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section B: Educational Records Detailed O & A level results or equivalent GCE O Level Examination Results GCE A Level Examination Results YEAR SUBJECTS Grade Grade Grade YEAR SUBJECTS Grade Grade Grade Schools attended from Secondary One (in chronological order) SCHOOL/ INSTITUTION & COUNTRY of Joining of Leaving Other Academic/ Professional Qualifications (in chronological order) QUALIFICATIONS OBTAINED Institution Year Page 2
section C: Particulars of Family Members ( Include yourself, parents/ guardian, unmarried brothers and sisters living with the family. For married applicants, include yourself, your spouse and children only.) Full Name (as in NRIC) Age NRIC Age Full Name (as in NRIC) Age Sex Sex Age Sex Marital Marital Status Sex Status Marital Status Occupation Occupation Occupation # # # Monthly # Gross Monthly Income Gross $ Income $ $ Employer/ School Employer/ Attending School Attending Relationship Relationship Applicant Applicant If there is no earned income, please state and provide supporting documents: - If there is no earned income, please state and provide supporting documents: - Source of family income: Source and amount of family per month: income: $ and amount per month: $ # Monthly Gross Income = ( Basic Monthly Income + MVC + NWC Allowances ) # Monthly Gross Income = ( Basic Monthly Income + MVC + NWC Allowances ) Page 3
section D: Other Information Sources of Finance 1) How are you financing the balance of your cost of study? Through personal savings and/or family family contributions, *Please furnish details Through a Bursary / Scholarship / Loan / Bond* Please specify: Amount: $ Donor/ Financier: Amount: Through Please specify: a Bursary Bursary / Scholarship Scholarship / Loan Loan / Bond* Bond* Period Donor/ of Bond: Please Financier: specify: Amount: Donor/ Financier: 2) Have you made any previous application to MENDAKI for Scholarships, Study Loan or Tertiary Tuition Amount: Period Fee of Subsidy $ Bond: (for Malay students in local institutions)? Yes / No Period of Bond: 2) If yes, Have please you furnish made details: any previous application to MENDAKI for Scholarships, Study Loan or 2) Have Tertiary you Tuition made Fee any Subsidy previous (for application Malay students to MENDAKI in local for institutions)? Scholarships, Yes Study / Loan No or Tertiary Tuition Fee Subsidy (for Malay students in local institutions)? Yes / No TYPE OF APPLICATION Applied Outcome Amount Awarded If yes, please furnish details: If yes, please furnish details: TYPE OF APPLICATION TYPE OF APPLICATION Applied Applied Outcome Outcome Amount Awarded Amount Awarded Authorisation (Overseas Students Only) Upon my successful application, I hereby authorise the following representative to act on my behalf on matters pertaining to my loan: Authorisation (Overseas Students Only) Name For of Representative: Upon correspondent, my successful I application, hereby authorise I hereby the authorise following the representative following representative to act on to my act behalf on my on behalf matters on matters pertaining pertaining to my to my loan: Name of Representative: Relationship to Applicant: (only immediate family members) NRIC No: S Relationship to Applicant: (only immediate family members) Address: NRIC No: S Address: Telephone: (Residence) (Mobile) (Office) (Pager) Telephone: (Residence) (Mobile) (Office) * Delete where not applicable. (Pager) section E: Declaration by Applicant y pp section E: Declaration by Applicant * Delete where not applicable. I hereby declare that the information given in this application is true and correct, and that I have I hereby not declare wilfully suppressed that the information any material given fact. in this application is true and correct, and that I have I hereby not declare wilfully suppressed that the information any material given fact. in this application is true and correct, and that I have not wilfully suppressed any material fact. I understand that the acceptance of this application by Yayasan MENDAKI does not bind MENDAKI I understand to approve that the acceptance the loan applied of this for application and that MENDAKI by Yayasan is at MENDAKI a liberty to does reject not the bind application MENDAKI to without approve assigning the loan any applied reason for for and doing that so. MENDAKI is at a liberty to reject the application without assigning any reason for doing so. Approval shall only be confirmed when I receive the letter of offer from MENDAKI. Applicant s Signature Applicant s Signature Page 4
section section F: F: Sureties Guarantors Applicants are required to furnish 2 guarantors acceptable to MENDAKI. The acceptability of the 2 guarantors will be at the discretion of the Loans Committee. The guarantors must fulfill the following requirements and agree to be present at Wisma MENDAKI for the signing of the loan agreement when the loan has been approved : Singaporeans Between the age of 21 and 55 years old Gross monthly income of at least $1,500 and above Gainfully employed for the past 1 year Must not be the applicant s parents, siblings or staying in the same household The first and second guarantor must not be from the same household Guarantors must submit a copy of their NRIC and recent income slip (the information will be kept confidential) Update latest address by giving a photocopy of their NRIC at the time of final cheque disbursement Self-employed guarantors must submit their latest IRAS form or CPF statement GUARANTOR SURETY 1 1 1) Full Name (Block letters) *Mr/Mrs/Miss: 2) Address: 3) Telephone: (Residence) (Mobile) (Office) (Pager) * Explanatory Notes 5 Sex Male Female M F 7 Citizenship Singapore Citizen 1 Permanent Res 2 Others 3 4) of Birth: / / 5) Sex: 6) NRIC No: S 7) Citizenship: 8) Relationship to Applicant: 9) Occupation: 10) Name & Address of Employer: Office Telephone: 11) Gross Monthly Income : 12) Are you standing as surety for any other person? Yes / No* Have you ever been made bankrupt or become insolvent? Yes / No* Are there any outstanding judgement/ court cases against you? Yes / No* If yes please furnish details: Declaration by Sureties Guarantor 1 I hereby declare that the information given in this application is true and correct, that I have not wilfully suppressed any material fact. Signature of Guarantor of Surety 1 1 * Delete where not applicable Page 5
GUARANTOR SURETY 1 2 1) Full Name (Block letters) *Mr/Mrs/Miss: 2) Address: 3) Telephone: (Residence) (Mobile) (Office) (Pager) * Explanatory Notes 5 Sex Male Female M F 7 Citizenship Singapore Citizen 1 Permanent Res 2 Others 3 4) of Birth: / / 5) Sex: 6) NRIC No: S 7) Citizenship: 8) Relationship to Applicant: 9) Occupation: 10) Name & Address of Employer: Office Telephone: 11) Gross Monthly Income : 12) Are you standing as surety for any other person? Yes / No* Have you ever been made bankrupt or become insolvent? Yes / No* Are there any outstanding judgement/ court cases against you? Yes / No* If yes please furnish details: Declaration by Sureties Guarantor 2 I hereby declare that the information given in this application is true and correct, that I have not wilfully suppressed any material fact. Signature of Guarantor of Surety 1 2 Delete where not applicable Use Checklist to assist you in ensuring that all necessary documents are submitted. * Delete where not applicable Use Checklist to assist you in ensuring that all necessary documents are submitted. Please tick )the appropriate selection in the available boxes. Please tick ( )the appropriate selection in the available boxes. section section G: G: Checklist I have submitted a photocopy of each of the following: Yes No NA a. My Birth Certificate & NRIC b. All my educational certificates from O level c. Pay-slips of Applicant (if applicable) d. Letter of Acceptance/ Admission from Polytechnic or University or latest examination result e. Supporting documents on the course fees and duration of course f. Payslips or official statements of gross monthly income or Income tax assessment returns of working family members ( Section C) g. NRICs and Payslips or official statements of gross monthly income or Income tax assessment returns of sureties ( Section F) Page 6