Hsbc Scholarship App Undergra

8/3/2019 Hsbc Scholarship App Undergra

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Page 1 of 7HSBC Bank Malaysia Berhad(Company number 127776-V)

Head, Group Communications (Malaysia)

& Corporate Sustainability Department

HSBC Bank Malaysia Berhad

No.2 Leboh Ampang,

50100 Kuala Lumpur Date:________________

Dear Sir/Madam

Re: Application for HSBC Scholarship Awards 2009 (Undergraduate Programme)

I, _____________________________________ (name of applicant) would like to apply for the HSBC

Scholarship 2009. Please find attached the following documents:

1. Scholarship Application Form

2. Photocopy of NRIC

3. Academic results (Certified true copies)

i) SPM (or other equivalent)

ii) STPM (or other equivalent)

iii) MUET (or other equivalent)

iv) Latest academic results (if not a 1st

year student)

v) Other academic qualifications

4. Copy of letter of offer from university / college (Certified true copies)

5. Fee payment structure from university / college (Certified true copies)

6. EA Form (Parent/s) (Certified true copies)

* Incomplete application will be automatically disqualified

Thank you

Yours sincerely,

____________________________

Signature

Name:_________________________________

NRIC No:______________________________


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Instructions:

Please attach all certified true copies of examination certificates and testimonials.

Only short listed candidates will be notified via email.

Incomplete applications will be automatically disqualified.

Please return the completed form to:

HHSSBBCC SSCCHHOOLLAARRSSHHIIPP AAPPPPLLIICCAATTIIOONN -- UUNNDDEERRGGRRAADDUUAATTEE

GGrroouupp CCoommmmuunniiccaattiioonnss ((MMaallaayyssiiaa))

&& CCoorrppoorraattee SSuussttaaiinnaabbiilliittyy DDeeppaarrttmmeenntt

HHSSBBCC BBaannkk MMaallaayyssiiaa BBeerrhhaadd

88tthh

FFlloooorr,, BBaanngguunnaann HHSSBBCC

NNoo.. 22,, LLeebbuuhh AAmmppaanngg

5500110000 KKuuaallaa LLuummppuurr

Closing date: 10 July 2009

Section A Personal Details (To be completed by applicant)

Full Name:

NRIC No.: Gender:

Date of Birth: Age:

Correspondence Address:

Home Address (if different from correspondence address):

Tel No. (House/

Mobile):

E-mail

Address:

Section B Family Details

Father (or guardian) Mother (or guardian)

Name: Name:

Relationship: Relationship:

Nationality: Nationality:

Occupation: Occupation:

Employer: Employer:

Monthly

Gross Income:

Monthly Gross

Income:

Please affix a

recent photograph

of applicant (non

returnable)

HSBC Scholarship Awards 2009

Application Form

(Undergraduate Programme)


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Name of Siblings

(Brothers & Sisters)Age Relationship

Marital Status

(Married /

Single)

Occupation (if in school or

employment, name and address

of school or employer)

Monthly Gross

Income

Section C Field of Study

Course of Study:

University / College /

Institute:

Type of University / College /

Institute:

Public University ( ) Private University / College ( )

Intake Date:

(MMM/YY)

Expected date of

Completion:

Tuition Fee:

(for the whole programme)

- Please indicate fee to be

paid by student

If you are not a first year student, please indicate your

latest examination results

Section D Secondary Education

SPM/ O Level or other equivalent No of distinction (Grade 1A and 2A): ___________

STPM/ A Level or other equivalent No of distinction (Grade A): __________ (Grade B) : _____________

MUET Level or other equivalent Results: __________________

Section E Other EducationOther Qualifications:

(Diploma / Matriculation / Foundation)

Awarded by:

(Institute / College / University)

Results (CGPA):


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Section F Other Financial Assistance

1. Are you presently receiving any financial assistance from any institutions/foundations/government? Yes ( ) No ( )

Yes, please

furnish details:

2. Do you have Perbadanan Tabung Pendidikan Applied ( ) Approved ( ) No ( )

Tinggi Nasional (PTPTN) loan?

3. Have you applied for any other Scholarships/Grants/Educational Loan? Yes ( ) No ( )

Yes, please furnish details: No, why

Section G Essay

1. About yourself / family background (maximum of 100 words)


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2. Why do you need a scholarship from HSBC? (maximum of 200 words)

3. What would you do if you were not offered this scholarship? (Maximum of 200 words)


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4. Explain about the course you have selected and why? (Maximum of 100 words)

Section H Declaration By Applicant

I agree and accept that if I am successful in my application,

i. HSBC Bank Malaysia Berhad (HSBC) will notify me in writing to formally offer me the scholarship;

ii. I will be required to enter into a formal contract with HSBC and shall observe the terms and conditions set out therein.

iii. HSBC will use all information including my personal data strictly for purposes relating to the Scholarship Awards, including the

disclosure and transfer thereof to the selection committee and the media where necessary.

iv. The information including any photo, visual and audio recording may also be used by HSBC or any of its Group Companies for

publicising the Scholarship Awards.

I hereby declare that the information given in this Application Form and in the documents (if any) attached hereto in support of my application is

true and correct and that I have not suppressed any material fact. I agree and accept that if any information in this Application Form (including,

without limitation, my particulars and the answers given in the questionnaire section) and in the attached documents (if any) is found to be false

and/or inaccurate, my application shall be rejected; and where the scholarship has already been awarded to me, HSBC shall have the discretion

to withdraw the same and I will reimburse HSBC all sums that have been released for my benefit under the Scholarship Award.

I undertake to furnish the Bank with additional documents and/or information as and when required by HSBC.

Name : I/C No.:

Signature : Date: ...

Referee:

Name: Address:..

Relationship:.. Contact Number:

Known for: . Months/years Profession: ..


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SURVEY FORM

HSBC Scholarship Awards 2009

We would appreciate receiving your comments on this programme. This will help us review and improve

our programmes in the future.

1. How did you hear about the HSBC Scholarship Awards?

HSBC Website (www.hsbc.com.my) : ( Y / N )

Other website (please specify which website) : __________________________________________

Newspaper (please specify which newspaper) : __________________________________________

University / College / Teachers (please specify which institution) : ______________________________

Existing / Past HSBC Scholarship Recipient : __________________________________________

Others (please specify) : __________________________________________

2. Which of these criteria of the HSBC Scholarship programme appeals to you?(please rate accordingly, 5 being the most appealing)

Scholarship Amount : 5 4 3 2 1

No restriction on field of studies : 5 4 3 2 1

No bonding required : 5 4 3 2 1

Education loan is permissible : 5 4 3 2 1

Others (please specify) : ___________________________________________________

Name : ___________________________________ NRIC No : __________________________________

Thank you for your co-operation.

Hsbc Scholarship App Undergra

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