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Download Acknowledgement Card MUHAMMADIYAH  · PDF fileAcknowledgement Card MUHAMMADIYAH SCHOLARSHIP Ibnu Taimiyah and Ibnu Sina Awards Photocopy of NRIC or passport Recent Passport size

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  • Acknowledgement CardMUHAMMADIYAH SCHOLARSHIPIbnu Taimiyah and Ibnu Sina Awards

    Photocopy of NRIC or passport

    Recent Passport size photograph

    Copies of all certificates obtained

    Transcript of exam results

    Testimonials

    Letter of offer from relevant institute

    Mission Statement

    Appendix A: Report by referee

    Self address envelope with stamp

    Please submit the missing item/s by:

    Name of applicant:

    This is to acknowledge receipt of your application.

    The application is complete

    is incomplete and the following items have not been received

    MUHAMMADIYAH SCHOLARSHIPIbnu Taimiyah and Ibnu Sina AwardsMuhammadiyah Association14, Jalan Selamat, Singapore 418534. Tel: 2427388

    To:

    From:

    (Name of applicant)

    (Address of applicant)

    Please affix

    stamp here.

  • APPLICATION FORMMUHAMMADIYAH SCHOLARSHIPIbnu Taimiyah and Ibnu Sina Awards

    Photocopy of NRIC or passport

    Recent Passport size photograph

    Copies of all certificates obtained

    Transcript of exam results

    Testimonials

    Letter of offer from relevant institute

    Mission Statement

    Appendix A: Report by referee

    Self addressed envelope with stamp

    Page 1 of 7Page 1 of 7

    Friday, 10th August 2012All applications must reach Muhammadiyah Association by

    Please send your application to: Muhammadiyah Scholarship 2012Muhammadiyah Association14, Jalan Selamat,Singapore 418534

    Only shortlisted applicants will be interviewed.

    Successfull applications will be asked to sign a letter of undertaking

    and to produce two guarantors.

    Please write clearly and neatly within the spaces provided.

    This form comprises 7 pages including this page.

    Incomplete applications will not be accepted.

    Please tick the checklist below and ensure all required documents have been provided.

    For official use:

    Reference No: /2012

    Date of Receipt:

  • APPLICATION FORMMUHAMMADIYAH SCHOLARSHIPIbnu Taimiyah and Ibnu Sina Awards

    1. personal particulars

    Name

    Permanent Address:

    Date of Birth: Age:

    Marital Status:

    Recent Photographof Applicant

    (Passport Size)

    Tel. (Res.)

    2. referees (please see appendix A)

    Mailing Address (If different from above):

    H/P No:

    Email:

    Office No: No. of Children:

    MarriedSingle

    Widowed Divorced

    Singapore

    Nationality:NRIC / Passport No:

    Singapore PR Others:

    Name

    Address

    Name 1:

    Name ofDesignation: Organisation:

    Name 2:

    Name ofDesignation: Organisation:

    Relationship to Applicant: Mobile No: Tel. No. (Res):

    NEXT-OF-KIN 1:

    Name

    Address

    Relationship to Applicant: Mobile No: Tel. No. (Res):

    NEXT-OF-KIN 2:

    Page 2 of 7

  • APPLICATION FORM FOR MUHAMMADIYAH SCHOLARSHIP

    3. academic background

    Qualification Obtained

    From Yr:(mm/yy)

    To Yr:(mm/yy)

    TERTIARY EDUCATION:

    Awarding Institution

    4. application history

    Are you applying for any other scholarship? No Yes

    If Yes, please specify which scholarship and from which organisation.

    Have you ever been awarded any scholarship before? No Yes

    If Yes, please specify which scholarship, what year and from which organisation.

    -

    -

    -

    Qualification Obtained

    From Yr:(mm/yy)

    To Yr:(mm/yy)

    POST-SECONDARY EDUCATION:

    Name of School / Institution

    -

    -

    -

    Qualification Obtained

    From Yr:(mm/yy)

    To Yr:(mm/yy)

    SECONDARY EDUCATION:

    Name of School

    -

    -

    -

    Name: Awarded by:

    1. Name: Year: Awarded by:

    1. Name: Year: Awarded by:

    Have you ever applied for Muhammadiyah Scholarship? No Yes

    If Yes, please specify what year.

    # Please attach copies of certificates obtained and transcripts of exam results.

    Page 1 of 7Page 3 of 7

  • APPLICATION FORM FOR MUHAMMADIYAH SCHOLARSHIP

    5. work experience (current occupation first)

    Job Description:

    From Yr:(mm/yy)

    To Yr:(mm/yy)

    Name of Company

    Designation: Status: Full Time Part Time

    6. voluntary experience

    -

    1.

    Job Description:

    From Yr:(mm/yy)

    To Yr:(mm/yy)

    Name of Company

    Designation: Status: Full Time Part Time

    -

    2.

    Job Description:

    From Yr:(mm/yy)

    To Yr:(mm/yy)

    Name of Company

    Designation: Status: Full Time Part Time

    -

    3.

    Job Description:

    From Yr:(mm/yy)

    To Yr:(mm/yy)

    Name of Institution

    Designation:

    -

    1.

    Job Description:

    From Yr:(mm/yy)

    To Yr:(mm/yy)

    Name of Institution

    Designation:

    -

    1.

    Page 1 of 7Page 4 of 7

  • APPLICATION FORM FOR MUHAMMADIYAH SCHOLARSHIP

    7. intended course of study

    Please provide details of the degree/diploma course that you will be or are currently pursuing.

    Institution: Status: Full Time Part Time

    Title of course: Duration of course: Years

    Subjects Offered: Date of enrollment:

    Description of course:

    Do you have a confirmed letter to pursue this course? No Yes

    Please attach a statement explaining why you are applying for this scholarship. What are your goalsand aspirations? What would you like to achieve after obtaining your degree / higher qualifications?Attach a separate sheet of paper. (Maximum 1500 words)

    Have you ever attended any of Muhammadiyahs classes? No Yes

    If yes, please name the ustadz.

    Name of applicant: Signature:

    8. mission statement

    9. others

    I confirm that the information provided by me on this form is correct. I understand that any false or inaccurate information or omission of information will render the application void and invalid.I will withdraw from the programme and reimburse any scholarship monies received if I am selected on the basis of such information.

    9. declaration

    Page 5 of 7

    (If yes, please attach)

    Date:NRIC No:

  • APPLICATION FORMMUHAMMADIYAH SCHOLARSHIPIbnu Taimiyah and Ibnu Sina Awards

    appendix A

    Name of applicant:

    Name of referee:

    Name of organisation: Designation:

    Email: Mobile / Tel. No:

    Relationship to applicant: No. of years known:

    This form must be furnished by the 1st referee. Each completed report must be sealed and signed across the seal by the referee and returned to the applicant. The report by the referee must be submitted together with the application form.

    1. How would you rate the applicants ability in undertaking the higher studies?

    2. What do you consider to be the applicants strengths and weaknesses?

    3. Additional comments by the referee. We would appreciate any information or details about the applicant which would help in assessing the application.

    Page 6 of 7

    REPORT BY REFEREE 1

    Signature of Referee:Name of Referee:Date:

  • APPLICATION FORMMUHAMMADIYAH SCHOLARSHIPIbnu Taimiyah and Ibnu Sina Awards

    appendix A

    Name of applicant:

    Name of referee:

    Name of organisation: Designation:

    Email: Mobile / Tel. No:

    Relationship to applicant: No. of years known:

    This form must be furnished by the 2nd referee. Each completed report must be sealed and signed across the seal by the referee and returned to the applicant. The report by the referee must be submitted together with the application form.

    1. How would you rate the applicants ability in undertaking the higher studies?

    2. What do you consider to be the applicants strengths and weaknesses?

    3. Additional comments by the referee. We would appreciate any information or details about the applicant which would help in assessing the application.

    Page 7 of 7

    REPORT BY REFEREE 2

    Signature of Referee:Name of Referee:Date: