scholarshipapplicationform.docVIP

SCHOLARSHIP APPLICATION FORM Course applying for: Please tick next to course of choice. For SCPS applicants, please rank your course preference 1 and 2 if you would like to be considered for both the Master Public Management Programme in NUS and the Nanyang Fellows Programme in NTU. Senior Management Programme (NUS, July 2009) Preference: * 1 / 2 Nanyang Fellows Programme (NTU, July 2009) Preference: * 1 / 2 Master in Public Management (NUS, January 2010) PLEASE COMPLETE USING BLOCK LETTERS ONLY (A) PERSONAL PARTICULARS Name as in Passport (please underline family name): * Dr / Mr / Mrs / Miss / Mdm Name in Chinese Characters: Organisation: E-mail: Office Address: Designation: Office Telephone No.: Sex: * Male / Female Office Fax No.: Home Address: Date of Birth (DD/MM/YYYY): Home Telephone No.: Place of Birth: Mobile Telephone No.: Race: Marital Status: * Single / Married / Separated / Divorced / Widowed Religion: Name of Spouse: Passport No.: No. of Children: Passport Expiry Date: Level of English Language Proficiency Speaking : * Excellent / Good / Fair / Poor Present Citizenship: Reading : * Excellent / Good / Fair / Poor Previous Citizenship (if any): Writing : * Excellent / Good / Fair / Poor (B) PRESENT PREVIOUS EMPLOYMENT IN CHRONOLOGICAL ORDER (please list starting from most current employment) From (MM/YYYY) To (MM/YYYY) Designation Name of Organisation Nature of Job *Delete, as appropriate (C) TERTIARY EDUCATION (Please include undergraduate and postgraduate education. Also indicate any other courses currently enrolled in and completion date.) Name Location of University Degree/Course of Study Highest Qualification Full-time / Part-time / Distance Learning From (MM/YYYY) To (MM/YYYY)