MOULMEIN-CAIRNHILL CITIZENS’ CONSULTATIVE COMMITTEE c/o Pek Kio Community Centre, 21 Gloucester Road, Singapore 219458 Tel: 62990565
BURSARY AWARD APPLICATION 2015 Student’s Name: ______________________________________________________________ Sex: ________ [Full Name as in NRIC / Birth Certificate in Block Letters]
Home Address: _____________________________________________________ Contact No:_____________ Name of School/College/Institution:________________________________________Class Level(2015)______ Details of family member(s) staying in the same household No.
Name
Relationship
Age
Citizenship
Occupation
Monthly Income
Remarks
1 2 3 4 5 6 7 8 9 10 Declaration by the applicant I declare that to the best of my knowledge the particulars furnished in this Application Form and documents attached hereto are true and I have not wilfully suppressed any material fact. I also declare that I have met all the eligibility criteria listed overleaf.
___________________________________ *Applicant's / Parent’s / Guardian Name
__________________ Signature
_____________ Date
(* please delete where necessary)
REMARKS & RECOMMENDATION (from Principal or Head of Institution) School/College/Institute/Principal’s Remarks:______________________________________________ ___________________________________________________________________________________________________________________________ _____________________________________________ Name & Signature of Principal or Head of Institution For Official Use only:
_________________ School Stamp
Bursary Approved
_______________________________ Certified by Chairman Moulmein-Cairnhill Community Development & Welfare Fund (CDWF) Committee
______________ Date
Not Approved
________________________________ Approved by Chairman Moulmein-Cairnhill CCC
_________ Date
MOULMEIN-CAIRNHILL CITIZENS’ CONSULTATIVE COMMITTEE c/o Pek Kio Community Centre, 21 Gloucester Road, Singapore 219458 Tel: 62990565
RULES & REGULATIONS FOR BURSARY 1
Objective The objective of the Bursary Award is to provide financial assistance to enable students from low and lower-middle income families to continue with their education.
2
Eligibility a) Students who are residents of the Moulmein-Cairnhill division of the Tanjong Pagar GRC. b) Be a Singapore Citizen. c) Be a full-time student of a government or government-linked school or junior college or Preuniversity Centre or Institute of Technical Education (ITE) or Centralised-Institute or Polytechnic or University or Full-time Tertiary Institution in Singapore. d) Not currently in receipt of any other Bursary or Scholarship from any source other than the Moulmein-Cairnhill Citizens’ Consultative Committee (Moulmein-Cairnhill CCC). Students who have received (or will receive) EDUSAVE or other bursaries / scholarships for Year 2015 are ineligible. e) Gross monthly household income below $5,000 or per capita monthly income less than $1,250 (computed based on the gross monthly household income divided by the number of household members).
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Method of Application Certified true copies of the following documents must be attached to the completed Application Form (Please do not attach your original documents): a) Student’s birth certificate / identity card or adoption certificate; b) Household members’ NRICs (including Parents, Grandparents, Siblings and etc). c) Final examination (Year 2015) results (for applicants from schools / JCs / CIs) or latest available examination results (for applicants from ITEs, Polytechnics, Universities or other tertiary institutions). d) The latest payslips or latest income tax returns of applicant's parents/guardians or a statutory declaration on monthly income if parents/guardians are unemployed.
4
Closing Date of Application The duly completed Application Form, with the above-mentioned attachments, must be submitted in person at the following locations, by 9.00pm on Monday, 23 November 2015. Pek Kio Community Centre 21 Gloucester Road, Singapore 219458 Tel: 6299 0565 Opening Hours: 9am to 10pm (Closed on public holidays)
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Tanglin Community Club 245 Whitley Road, Singapore 297829 Tel: 62513922 Opening Hours: 9am to 10pm (Closed on public holidays)
Category of Bursary Recipient & Quantum of Each Award (per student per year) (a) (b) (c) (d) (e) (f)
Lower Primary (P1/P2/P3) Pupil Upper Primary (P4/P5/P6) Pupil Secondary (S1/S2/S3/S4/S5) Student Junior College/Centralised Institute/Pre-University Student Institute of Technical Education (ITE) Student Polytechnic / University Student
Note: Total value of the Bursaries awarded to students from the same family is subject to a maximum of $800.
6 7 8 9 10
Providing false information will lead to disqualification. Forms submitted by post or fax will not be entertained. Late or incomplete applications will not be considered. All documents submitted are not returnable. The decision made by the Moulmein-Cairnhill Citizens’ Consultative Committee is final.
NOTE : ALL INFORMATION SHOULD BE FILL IN ENGLISH CAPITAL LETTERS ONLY. 1 NAME OF SECRETARIAT. : 2 NAME OF DEPARTMENT. : 3 NAME OF INSTITUTE / OFFICE. : 4 OFFICE ADDRESS. : PHONE NUMBER. 5 NAME AND DESIGNATION OF HEAD OF. INSTITUTE/OFFICE. CONTACT NUM
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