Page 1 of 8 Application for the admission of Category E applicants to ...

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Application for the admission of Category E applicants to undergraduate courses in Academic Year 2015-2016Please check your application before submission. The Office of Admissions cannot be held responsible for the accuracy of your application.

As you are on a secure site, and for security reasons, please note that you are only given 30 minutes to complete the application form. You will be logged out if you take more than the allocated time.

If you would like to provide details in the "Exceptional talents and achievements" section, you are strongly encouraged to pre-type your text using a text editor and then copyit over to the allocated box in the form.

The application form consists of the following sections. Please complete all sections.1. Personal Particulars 8. Disabilities and Special Needs2. Contact Information 9. Next-of-Kin Information3.. Academic Qualifications 10. Personal Identification Number4. University/Tertiary Education 11. Application Fee5. Outstanding Achievements 12. Financial Aid6.. Choice of Courses 13. Other Information7. National Service and Employment History 14. Declaration

Fields that are marked with * are mandatory.

1. PersonalParticulars

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Full Name * (e.g. TAN KOK LENG)(full name as printed on your NRIC/passport/Birth Certificate)

Given Name * (e.g. KOK LENG)Note: Click here for guide on how to key in Given Name

Family Name * (E.g. TAN)Note: Click here for guide on how to key in Family Name

Date of Birth * / / (dd / mm / yyyy eg. 08 / 02 / 1989)

Gender *

Citizenship *

Singapore Permanent Resident Yes No (Please do not select ‘Yes’ if you are a Singapore Citizen.)

NRIC number/FIN S

Passport Number (To be filled in by non-Singapore Citizen. If you are a Malaysian, please enter your 12-digit Malaysian I/Cnumber)

Marital Status*

Race / Ethnic Group*

Religion*

2. Contact Information

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Postal Address *

Block/HouseNo. * (e.g. APT BLK 42)

Street Name/Building Name * Unit No. (e.g. #12-34)

State/City (You do not need to fill in "Singapore" here if you are providing a Singapore address)

Country *

Postal Code

Email * (Please ensure your email address will be in-use for at least another 12 months)

Alternate Email (Please ensure your alternate email is different from the above)

HomeTelephone*

(Please do not fill in country & area codes for Singapore number; for the 'number' field, please do not put hyphen or leave space in-between numbers, eg. Contact number should be keyed in as 12345678)Country Area Number

Handphone (Please do not fill in country & area codes for Singapore number; for the 'number' field, please do not put hyphen or leave space in-between numbers, eg. Contact number should be keyed in as 12345678)Country Area Number

3. Academic Qualifications Back to Top Next Section

Secondary EducationName of Secondary School City/Country From To

Examination Year Taken

Subjects Marks / Grade Obtained

Maximum Marks / Grade Possible

of 8Application for the admission of Category E applicants to undergraduate courses in A...

30/1/2015https://myaces.nus.edu.sg/uasonline2/catE/catESetup.do;jsessionid=8c9dad11cbb44803...

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English

Additional Mathematics

Physics

The above information is required to ascertain that you satisfy specific course pre-requisites. You may not have offeredsome of these subjects therefore information is not compulsory. Please leave the space blank if you have not taken the above subjects.

High School Education*Name of High School Enter Name of High School if not

found in listCity/Country From To

Examination IINDONESIAN SMU UAN (EBTANAS)NDONESIAN SMU UAN (EBTANAS) YearTaken

Please indicate type of results submittedActual

School 4th Term Results

If you are not submitting actual results, indicate the month that your actual results will be available

2015

For applicants with Actual Ebtanas (Science Stream) Results, please enter the following subjects - INDONESIAN, ENGLISH, MATHEMATICS, PHYSICS, CHEMISTRY, and BIOLOGY.

For applicants with Actual Ebtanas (Arts/Humanities Stream) Results, please enter the following subjects - INDONESIAN, ENGLISH, ECONOMICS, SOCIOLOGY, ANTHROPOLOGY, and CIVICS(i.e. Tata Negara)

For applicants with High School 4th Term (Science Stream) Results, please enter the following subjects - INDONESIAN, ENGLISH, MATHEMATICS, PHYSICS, CHEMISTRY, and BIOLOGY.

For applicants with High School 4th Term (Arts/Humanities Stream) Results, please enter thefollowing subjects - INDONESIAN, ENGLISH, and any 4 of the following 6 subjects : ECONOMICS, MATHEMATICS, SOCIOLOGY, ACCOUNTING, GEOGRAPHY, and HISTORY.

For applicants with High School 4th Term (Language Stream) Results, please enter the following subjects - INDONESIAN, ENGLISH, MATHEMATICS, GERMAN, CHINESE LANGUAGE, and HISTORY.

Examination Results

Subject Marks ObtainedWritten /Cognitive

Practical / Psychomotoric (Fill in if applicable)

Additional Information Please provide, if available

Date Taken Marks / Grade ObtainedIELTS (Please input the score for Academictesting only)

(Please enter Overall bandcomponent score only)

(Please enter Writing component score only)

(Please enter Reading component score only)

TOEFL PaperInternet

EL1119

MUET

SAT

Critical Reading

Math

Writing

SAT Subject Tests

Subject



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If you have chosen YES to the above question, please provide your academic results as follows

University Course

ACT Composite Score

Advanced Placement (AP)

Subject

Students who are offering the Indian Standard 12 qualification may fill in their IIT/AIEEE (if applicable) below:AIEEE Rank State Rank

Country Rank

IIT Rank State Rank

Country Rank

Reason for transfer (please limit to 1500 characters)

Please provide your reason(s) for seeking a transfer which would assist the University to assess your application. Please leave this blank if you are a high schoolstudent who have not enrolled into a University.

chars remaining1500

4. University/Tertiary Education Back to Top Next Section

Are you a current / former (regardless of whether you have or have not graduated) student of the National University of Singapore (NUS), Nanyang Technological University (NTU), Singapore Management University (SMU), Singapore University of Technology & Design (SUTD), Singapore Institute of Technology (SIT), SIM University (UNISIM) and/or any other tertiary institutions (except polytechnics in Singapore)? (Please click here for more information)

Yes No

Note:

1. If your answer to the above question is 'Yes', please DO NOT use this form. Instead, you would belong to the category of "Transfer Applicants", and you would have to apply under this category of application. More details canbe found at: http://www.nus.edu.sg/oam/apply/transfer/admissionreq/BYA-admission.html.

2. You may like to note that any false declaration to this section may render this application invalid and NUS may at its discretion withdraw any offer of admission made to you on the basis of false declaration.

Are you a current / former student of any other university or tertiary institutions?

Yes No

Year Subject Marks / Grade Obtained

Maximum Marks /Grade Possible

GPA



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5. Outstanding Achievements Back to Top Next SectionThis section is an opportunity for you to list the activities that you have been involved in besides your academic work.

A list of activities that we may take into consideration is provided below. Please provide relevant details. If you wish to include particulars of referees, you should seek their consent before listing them. Please also inform them that the University might contact them for clarification.

You should indicate your achievements in the International Olympiad (Biology, Chemistry, Mathematics, Physics and Informatics) competitions under 'Activity 1'. You should leave it blank if you have not participated in any of the indicated Olympiads.

You may wish to provide other relevant details under 'Activity 2 and 3'.

You should also include a personal statement in the space provided in this section. The statement could elaborate on the achievements in the activities you had participated and how they relate to your interest in for the course of study you have chosen.

Do note that information declared in this section may be used in the selection of freshmen awards and scholarships and for admission to NUS under the Discretionary Admissions Scheme.

It is therefore important that you complete this section carefully.

Activity 1*

Level of achievement

Name of activity/ organisation/employer*

Level

Position Held

From*

To*

Name of contact person (if available)

Position of contact person

Telephone number

Fax number

You may wish to provide other relevant details under 'Activity 2 and 3'. You may also wish to elaborate on your involvement and achievements in these activities in an essay in this section. You must submit the relevant records/supporting documents for the information you provided.

Activity 2*



Level of activity Not ApplicableSchool level of activity Not ApplicablePosition Held

From*

To*



Telephone number

Fax number

Activity 3*



Level of acitivity Not ApplicableSchool level of activity Not ApplicablePosition Held

From*

To*



Telephone number

Fax number

Essay

This section is an opportunity for you to elaborate on the information you have provided earlier. You may discuss a special talent, a personal experience or an



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activity that you have been involved in that is relevant to the course you are applying for admission.

As your essay is limited to only 2000 characters, do present your ideas in a focused and thoughtful manner.

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6. Choice of Courses Back to Top Next SectionThere will be TWO parts in this section: (a) and (b).

In (a), please tell us your choice of Single Degree courses in order of your preference. You must complete (a) before you proceed to (b) to indicate your interest in the Double/Concurrent Degree programmes.

You need to complete (b) only if you are interested in the double/concurrent degree programmes.

a) Single Degree Courses

State your choice of course in order of preference. We will consider your choice in the order that you have indicated. For example, if you do not qualify for your first choice, we will consider you for your second choice and so forth, at no disadvantage. You may choose fewer than 8 choices but do not repeat the choices. For the latest update on courses, please refer to http://www.nus.edu.sg/oam/courses/course.html.

Note: For each choice, there is a Drop-Down-Menu comprising all single-degree courses which NUS offers Application for the Music course should be filed separately. Please refer to the Yong Siew Toh Conservatory of Music (NUS) website at http://music.nus.edu.sgStudents reading common Engineering will be streamed at the end of Year 1 to Biomedical Engineering, Chemical Engineering, Civil Engineering, Computer Engineering, Electrical Engineering, Environmental Engineering, Industrial & Systems Engineering, Mechanical Engineering or Materials Science & Engineering Students must indicate Dentistry as their first or second choice if they wish to be considered for admission to this course. Students must indicate Medicine as their first or second choice if they wish to be considered for admission to this course. Students must indicate Nursing as their first, second or third choice if they wish to be considered for admission to this course.Students must indicate Architecture as their first, second or third choice if they wish to be considered for admission to this course. Students must indicate Industrial Design as their first, second or third choice if they wish to be considered for admission to this course. Students must indicate Law as their first or second choice if they wish to be considered for admission to this course.

1st Choice* 5th Choice

2nd Choice 6th Choice

3rd Choice 7th Choice

4th Choice 8th Choice

b) Double/Concurrent Degree Programmes

Please fill in this section if you are interested in a double/concurrent degree programme.

Note that:

1. If you wish to apply for a double/concurrent degree programmes, you must include at least one of the faculties/schools offering the double/concurrent degree programme as one of your choices in (a).

2. The faculties / schools offering direct admission to double / concurrent degree programmes are Arts & Social Sciences (for Economics and Communications & New Media), Business, Computing, Engineering (except Engineering Science course), Law and Science (for Mathematics/Applied Mathematics and Life Sciences).

3. To be considered for the Business Administration & Law, Business Administration(Accountancy) & Law, Economics & Law, Law & Life Sciences, and/or Law & Master in Public Policy double/concurrent degree programmes, you must have listed Law as your first or second choice in the selection of a single degree course in (a). For more information, please click here.

4. To be considered for the Mathematics/Applied Mathematics & Computing (Computer Science) double degree programme, you must have listed Science and/or Computing (Computer Science) as one of your choices in (a).

5. To be considered for the Computing (Computer Science with Specialisation in Computational Biology) & Scientiae Magister in Computer Science-Computational Biology track (Brown University) concurrent degree programme, you must have listed Computing (Computer Science) as one of your choices in (a).

6. To be considered for the Computing (Computer Science) & Grad Scientiae Magistri (Scientia Computatoria) (Brown University) concurrent degree programme, you must have listed Computing (Computer Science) as one of your choices in (a).

7. To be considered for the Computing (Information Systems) and Master of Science (Management) (NUS) concurrent degree programme, you must have listed Computing (Information Systems) as one of your choices in (a).

You will be evaluated for admission to a double/concurrent degree programme if you are successful in gaining admission into a faculty /school that offers one of thedouble/concurrent degree programmes.

Some double/concurrent degree programmes require a selection interview. Only shortlisted candidates will be informed to attend the interview(s) for the double/concurrent degree programmes. You may be shortlisted for one or more interviews if you indicate more than one choice for your Double/Concurrent DegreeProgramme options. Please note that Double/Concurrent Degree Programmes are highly competitive. If you are interested in more than one double/concurrent degree programme, please select the programmes in order of preference.

1stChoice2nd Choice3rd Choice4th Choice

Note: For each choice, there is a Drop-Down-Menu comprising:

Business Administration & Communications and New Media Business Administration (Accountancy) & Communications and New MediaBusiness Administration & Computing (Computer Science)Business Administration & Computing (Information Systems)Business Administration (Accountancy) & Computing (Computer Science) Business Administration (Accountancy) & Computing (Information Systems) Business Administration & Law Business Administration (Accountancy) & LawBusiness Administration & Master of Science (Management)Business Administration (Accountancy) & Master of Science (Management) Business Administration & Master in Public Policy Business Administration (Accountancy) & Master in Public Policy Engineering (Except Engineering Science) & Business Administration Engineering (Except Engineering Science) & Business Administration (Accountancy)Engineering (except Engineering Science) and EconomicsEconomics and Business Administration Economics and Business Administration (Accountancy) Economics and LawLaw and Master in Public Policy Law and Life SciencesMathematics/Applied Mathematics & Computer ScienceComputing (Computational Biology) & Scientiae Magister in Computer Science-Computational Biology track (Brown University)



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Employment History

Computing (Computer Science) & Grad Scientiae Magistri (Scientia Computatoria) (Brown University) Computing (Information Systems) and Master of Science (Management) (NUS)

7. National Service and Employment History Back to Top Next SectionPlease click here for more information on NS Status before completing this section.

Please choose "Not Applicable" if you do not need to or are not serving National Service in Singapore.

If you are waiting to be enlisted for NS, please select "Registered/Waiting to be enlisted" for your "NS Status." Unless you have indicated your NS status as "Not Applicable", "Registered" or "Exempted", you are required to indicate your NS date.

National Service Status *Enlistment Date (Not applicable if your NS status is "NA" or "EXEMPTED" or "Registered".)

ORD/Disruption Date

If you are exempted from National Service, you are required to submit the necessary documents (endorsed by MINDEF) to Office of Admissions. Please click herefor more information on submission of supporting documents.

If you are at least 25 years old as of 1 July 2015 with at least 4 full years of relevant full-time working experience, would you like to be considered as a Mature Candidate?

Yes No

If you have answered "Yes", please complete both Parts (a) and (b) in this section.

(a) Particulars of Referrals

Please provide 2 referrals (compulsory) from at least one employer. Referrals must be at supervisory level and above.

Referee 1

Name of Company

Name of Referee

Telephone number (Country & area codes are required only for non-Singapore number)

Country Area Number

Referee 2

Name of Company

Name of Referee

Telephone number (Country & area codes are required only for non-Singapore number)

Country Area Number

(b) Employment HistoryPlease indicate the name of the company and length of service with each employer which makes up the 4 full years of relevant working experience, starting from the most current employer.

Name of Company Position From To

(c) SAT Test ScoresPlease provide your SAT Test scores in Section 6 of this Form if you have indicated that you wish to be considered as a Mature Candidate.

8. Disabilities and Special Needs Back to Top Next SectionHave you had or do you have any communicable diseases, mental illness, colour blindness, and/or disabilities (including but not limited to chronic illnesses, visual or other physical constraints or limitations) which may or may not cause you to require special assistance or facilities while studying at the University? *

Yes No

If yes, please provide details below and submit medical documents and/or other supporting documents.



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If you require any form of special assistance and/or facilities if admitted to the University, please provide details below.

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Note: This information will enable the University to develop a complete profile of an applicant and determine whether he/she might need additional resources in his/her studies. The University does not, however, guarantee the provision of special aid (financial or otherwise) to any student.

Medical conditions Please provide more details on your medical condition in the box

Medical condition 1:

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1000

9. Next-of-Kin Information Back to Top Next Section

Please provide a contact person in case of an emergency.

Name of Next-of-Kin / Guardian *

Relationship with Applicant*

Occupation *

Telephone * (country & area codes are required only for non-Singapore number)

Country Area Number

Handphone / Pager (country & area codes are required only for non-Singapore number)

Country Area Number

10.Personal Identification Number Back to Top Next Section

Enter an Admission PIN (8 alpha-numeric characters) (case sensitive)*

(8 alpha-numeric characters e.g. gwWg254x)

Re-enter your Admission PIN (8 alpha-numeric characters) (case sensitive)*

Please keep your PIN confidential. Your PIN is important and you will need it to access the following online facilities related to this application.

Uploading of supporting documentsOnline status enquiry Online reply to NUS' offer of admission Online appeal E-Payment via Credit Card

11.Application Fee Back to Top Next Section

A non-refundable application fee of SGD10 is payable. Please select one of the following modes of payment

Credit card [Visa/ MasterCard/ Amex only]. Payment can be made immediately via the web link located at theacknowledgement page after submitting your application.)

Bank draft/cheque made payable to 'National University of Singapore'

NETS at the Office of Admissions, NUS

* Payment must be made by 21 February 2015. Applications without full payment will not be processed.

12.Financial Aid Back to Top Next Section

NUS offers Financial Aid schemes such as loans, bursaries and work-study opportunities in order to help financially needy students meet their study expenses in NUS.

Do you intend to apply for Financial Aid offered by NUS to support your studies in NUS? *

Yes No

13.Other Information Back to Top Next Section

Have you ever been convicted of an offence by a court of law or a military court (court martial) in any country or are there any court proceedings pending against you anywhere in respect of any offence?

Are you currently, or have you ever been, charged with or subject to disciplinary action for any type of misconduct, scholastic or otherwise, at any educational institution?

Are you currently, or have you ever been, under investigation or subject to enquiry in respect of any misconduct, scholastic or otherwise, at any educational institution?

If your answer to all the above questions is ‘No’, please click ‘No’ below. * No

Or

If your answer to any or all of the above questions is ‘Yes’, please click ‘Yes’ below and also provide a full



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statement of the relevant information in the box below and/or on a separate sheet of paper (and attach the relevantdocuments).

Yes

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14.Declaration Back to TopI hereby declare that all information provided by me in connection with this application is true, accurate and complete. I understand that any inaccurate, incomplete or false information given or any omission of information required shall render this application invalid and NUS may at its discretion withdraw any offer of acceptance made to me on the basis of such information or, if already admitted, I may be liable to disciplinary action, which may result in my expulsion from NUS. And I hereby authorise NUS to obtain and verify any part of the information given by me from or with any source (such as Ministry of Education), as it deems appropriate.

I declare and warrant that for any personal data of other individuals disclosed by me in connection with this application, I have, prior to disclosing such personal data to NUS, obtained the appropriate consent from theindividuals whose personal data are being disclosed, to permit NUS to collect, use and disclose such personal data for purposes related to this application, as set out fully in the Personal Data Notice & Consent.

I agree that all such information provided by me in connection with this application may be disclosed to authorised NUSpersonnel or third parties on a need-to-know basis for purposes related to this application, as set out fully in thePersonal Data Notice & Consent. Third parties include (i) the Ministry of Education, other government agencies or statutory bodies or non-government agencies authorised to carry out specific Government services or duties and (ii) persons or organisations providing students with financial aid.

I have read and agree to the terms and conditions contained in the Personal Data Notice & Consent.

I agree to receive marketing, advertising and promotional information from NUS via postal mail, electronic mail, SMS or MMS and/or fax.

Yes No

I agree to receive marketing, advertising and promotional information from NUS at my telephone number provided above via voice call / phone call.

Yes No

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