SM BRIDGING PROGRAMMEApplication for a Duplicate Copy of the SM Bridging Course Transcript

POINTS TO NOTE:1) You are to complete this application form in BLOCK letters. You will be required to submit documentary proof in support of your

request for a duplicate copy of your bridging course transcript.2) You are to submit this form to OAFA for endorsement and approval BEFORE making payment.3) Payment of $5.35 (inclusive of GST) by NETS, NETS CashCard and ez-link Card can be made during payment hours [Monday –

Thursday, 8.30am – 5.00pm and Friday, 8.30am – 4.45pm] at:One Stop @ SAC: 50 Nanyang Avenue, NS3-01-03, Academic Complex North, Singapore 639798

URL: http://www.ntu.edu.sg/has/Graduate/Pages/OneStopSAC.aspxOnline Map: http://maps.ntu.edu.sg/maps#q:NS3-01-03

4) The completed application form and the official receipt are to be submitted to OAFA (Level 3, Student Services Centre). You are required to produce the original application form and receipt.

5) Your transcript will only be ready for collection 5 working days after the submission of this application form and the payment receipt. The transcript can be collected during the following hours [Monday – Thursday, 8.30am – 5.00pm and Friday, 8.30am – 4.45pm] at:

OFFICE OF ADMISSIONS & FINANCIAL AIDLevel 3, Student Services Centre

42 Nanyang AvenueSingapore 639815

6) You are to collect your replacement bridging course transcript in person. You may not ask a friend to collect your bridging course transcript on your behalf. Replacement bridging course transcripts will not be sent out via post.

7) No refund will be given once payment has been made.

A. PERSONAL PARTICULARSName (as in passport):      

Name (in Chinese characters):     

Gender:M F

Passport No:      

FIN:     

Bridging No.:     

Matric No.:     

Mobile No. (Singapore):     

Email:     

SM Programme: SM2

SM Bridging Batch:     

Reason for request:     

B. DECLARATIONI declare that all information given in this form is true and accurate to the best of my knowledge and I have not wilfully suppressed any material fact. I understand that:1) I will render myself liable to appropriate action if the information provided turns out to be false or inaccurate.2) OAFA reserves the right to reject this request / application.

Name & Signature of Scholar: Date:      

C. FOR OAFA USE

① Status of Request: Approved Rejected

Processed by: Date:

② Payment Made: Yes No

Receipt Received: Yes No

Date of Collection: Processed by: Date:

T A L E N T O U T R E A C H S E C T I O N Office of Admissions & Financial Aid

Student Services Centre Level 3, 42 Nanyang Avenue, Singapore 639815Tel: +65 67906633 | Fax: +65 6794 6510 | Email: TalentOutreach@ntu.edu.sg

NOTE TO CASHIER:Please credit payment to M060370001-70602200