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Application for Admission (General Studies Programme)

1

SIM University (UniSIM)

Please paste a recent colour passport-sized photograph

461 Clementi Road Singapore 599491 Tel: 6248 9777 Fax: 6469 9312 www.unisim.edu.sg

(Please indicate your name & NRIC No. on the reverse of the photo)

Choice of Programme

Please tick
your choice of programme. Choose ONE only.  Bachelor’s

 Diploma

Intake (month/year)  Certificate

Please indicate the course(s) that you would like to take in your first semester. You can register for up to 20 credit units. Please tick
ONE box only. S/No

For Credit 1

Course Name (eg. Organisational Behaviour)

For Audit 2

1 2 3 4 5 6

Notes: 1 Students reading the course for Credit are required to complete all assignments and take the end of course assessment (examination). 2 Students auditing the course need not complete the end of course assessment and would receive a Certificate of Attendance at the end of the course. Audit mode does not apply to applicants enrolling for the Bachelor’s and Diploma in General Studies programme.

2

Personal Details

NRIC/FIN No:

Passport No: (for foreigners without FIN No.)

Title*: Mr / Ms / Mrs / Mdm /Dr (Delete where appropriate)

Full Name: (As it appears in your NRIC/Passport. Please underline surname. Full name will be used for student registration, degree certificates, transcripts and all correspondences)

Home Address: Postal Code Home Tel. No:

6

Handphone No:

E-mail Address: Marital Status:

Single

Date of Birth:

Married

/ dd

Others

/ mm

Preferred Mailing Address:

Home

Gender:

Female

Male

Office

Age: yyyy

Nationality:

Singaporean

Malaysian

Others (specify):

Residency Status:

Permanent Resident

Employment Pass/ Work Permit

Others (specify):

Race:

Chinese

Malay

Indian

Others (specify):

National Service (NS):

Regular

Completed full-time NS

Currently Serving full-time NS

Exempted

(for non-Singapore Citizens only)

Not Applicable

National Service Period from ___________to__________ (ORD) Length of full-time National Service served: ______years______months (eg. 2 years) (as at intake start date)

Length of full-time National Service required: ______years______months For Regulars, please only indicate the NS required. Indicate the rest of your working experience under Present Employment Year 2008

3

Past Enrolment as an UniSIM/SIM-OUC Student

Have you ever registered as a student of UniSIM or SIM-OUC? Yes. Year of Admission: ____________ 4

No

Present Employment Details

Company Name: Company Address:

Postal Code

General Tel No:

6

Industry Code:

0 2 0 -

Fax:

DID/Ext:

6

Refer to Code Table

Company Type:

Government Ministry

Statutory Board

Professional Body

Public Listed

Private

Others (please specify)

Name of Division/Department/Section:

Job Function Code: Refer to Code Table

Current Designation:

Current Designation level:

0 9 0 Refer to Code Table

No. of years/months in this company:

/

From: mm

Full-time

Part-time

yy

Gross Annual Income:

5

Past Employment Records

In chronological sequence, starting with your most recent past position: Period (mm/yyyy) Name of Company

Designation From

To

No. of Years/Months

*Full-time (FT) Part-time (PT)

1)

FT

PT

2)

FT

PT

3)

FT

PT

4)

FT

PT

5)

FT

PT

FT

PT

6) * Delete where appropriate

6

Summary of Working Experience

a) Total number of years/months of Full-time working experience (excluding National Service) (note: You must attach a letter of full-time employment with this application)

years

months.

b) Total number of years/months of Part-time working experience (excluding National Service)

years

months.

c) Total number of years/months of relevant working experience applicable to Programme applied (1st Choice)

years

months.

Year 2008

7

Educational Qualification Details

Qualification Level

Name of Qualification & Awarding Institution

Country

Period of Study

Master’s

Mode of Study

Fr: Awarding Institution

Country

To:

Country

Period of Study

Bachelor’s Country

No

Taken at SIM/SIM-OUC

Part-time

Yes

Full-time

No

mm/yyyy

To: Qualification Title

mm/yyyy

Name of Qualification & Awarding Institution

Country

Period of Study

Diploma

Mode of Study

Fr: Awarding Institution

Country

Taken at SIM/SIM-OUC

Part-time

Yes

Full-time

No

mm/yyyy

To: Qualification Title

mm/yyyy

Name of Qualification & Awarding Institution

Country

Period of Study

Certificate

Mode of Study

Fr: Awarding Institution

Country

Taken at SIM/SIM-OUC

Part-time

Yes

Full-time

No

mm/yyyy

To: Qualification Title

Qualification Level

Full-time

Mode of Study

Fr: Awarding Institution

Qualification Level

Yes

mm/yyyy

Name of Qualification & Awarding Institution

Qualification Level

Part-time mm/yyyy

Qualification Title

Qualification Level

Taken at SIM/SIM-OUC / UniSIM

mm/yyyy

Name of Qualification & Awarding Institution

Country

Other Qualifications ++

Period of Study Fr:

Awarding Institution

Country

Part-time mm/yyyy

To: Qualification Title

Mode of Study

Full-time mm/yyyy

“A” Level Qualification GCE ‘A’ Level (Singapore-Cambridge)

Number of ‘A’ level passes

Year of Award:

Number of ‘AO’ level passes Other GCE ‘A’ level equivalent (e.g., STPM, HSC, IB)

No. of passes ____________

Year of Award:

(please specify qualification title, awarding institution and country of qualification)

“O” Level Qualification GCE ‘O’ Level (Singapore-Cambridge)

Number of ‘O’ level passes

Year of Award:

Other GCE ‘O’ level equivalent (e.g., SPM)

No. of passes ____________

Year of Award:

(please specify qualification title, awarding institution and country of qualification)

Grading of English Language (as 1st Language) : Indicate scores for Test of English as a Foreign Language (TOEFL) or International English Language Testing System (IELTS) if you have taken them TOEFL IELTS

TOEFL; Year of award

(Total score:

: Test of Written English score ____________ )

IELTS; Year of award (Total score: : Score of Sub-Test 1: /2: /3: /4: ) I will be taking the TOEFL / IELTS* on _______________________ (date) Results will be released on ____________________. I agree to send a copy of the results to SIM University upon request.

Other programmes that you are currently pursuing (including SIM and UniSIM programmes) Programme(s)

Institution

Date of Final Examination

1 2 ( Please submit certified copies of all transcripts/result slip available todate) ++ If you have more qualifications under this category, please provide on a separate sheet of paper. * Delete where appropriate

Year 2008

8

To be Completed by Company (applicable to those under company sponsorship and Corporate Member)

a) Company Sponsorship Company is sponsoring the applicant for: (i) course fee

Yes

No

(ii) membership fee

Yes

No

Company Certification We certify that all statements made on this application are true and complete to the best of our knowledge.

Name and Designation of Authorised Company Official

Contact No.

Signature & Date

Company Stamp

Yes

b) Company is a SIM Corporate Member

No

Please enclose a letter duly signed certifying the staff taking the programme is under employment with the company and provide the SIM Corporate Membership number. If there is no verification, the staff taking the programme will be invoiced for membership fee as a SIM Student Member.

Code Table Industry Code Agricultural, Forestry & Fishing

101

Mining & Quarrying

201

Manufacturing Food, Beverage, Tobacco Textiles, Wearing Apparel Leather Products, Leather Apparel Timber & other Wood Products, Furniture Paper Products Printing and Publishing Industrial Chemicals, Gases Chemical Products Petroleum Refineries and Petroleum Products Rubber and Plastic Products Earthenware and Glass Products Cement and Concrete Products Iron and Steel, Tin Smelting Fabricated Metal Products, Machinery Electrical and Electronic Products (including computers)

301 302 303 304 305 306 307 308 309 310 311 312 313 314

Manufacturing Transport Equipment (Shipbuilding/Repairing Marine Engineering/Offshore Rigs, Motor Vehicles, Motor Cycles, Bicycles & Aircrafts) Instrumentation Equipment, Photographic & Optical Goods Other Manufacturing Industries

Transport, Storage & Communications Storage and Warehousing Travel Agencies

317 399

Electricity, Gas & Water Gas Manufacture and Distribution

401

Construction Building Construction, Electrical Wiring & Installation, Plumbing

501

Commerce Wholesale and Retail Trade (including Import and Export) Restaurants and Hotels Holding companies

601 602 603

Transport, Storage & Communications Land/Sea/Air Transport

701

702 703

316

315

Finance Insurance Real Estate and Business Services Banking and Financial Institutions 801 Insurance 802 Real Estate, Housing Development and Investment 803 Legal Services and Consultancy 804 Accounting, Auditing/Data Processing Services 805 Engineer, Architectural/Technical Services 806 Advertising Services/Employment Agencies 807 Medical, Dental Services 808 Management Consultants 809 Public and Private Bodies Government Ministries Statutory Boards Associations Professional Bodies Educational Bodies Armed Forces Others

901 902 903 904 905 906 999

Current Designation Level Top Management Senior Management Middle Management

1 2 3

Junior Management Non-Managerial Professional/Technical Exec. Non-Executive Staff

4 5 6

Sole Proprietor Student

7 8

Job Function Admin/Secretarial Advertising and Promotion General Management (CEO, MD, EXD) Civil Engineering Corporate Planning Board Membership (Chairman, BDIR) Physical Distribution/Warehousing Electrical/Electronic Engineering Plant and Industrial Engineering Finance and Accounting Hospitality Services HRM/HRD (Personal/Training) Legal Services Maintenance and Services

ADM1 ADV1 CEO1 CIV1 COR1 DIR1 DIS1 ELE1 ENG1 FA1 HOS1 HR1 LG1 MAN1

Mass Communication

MC1

Mechanical Engineering Manufacturing Management Information Systems Marketing and Sales Medical Services Production Project Management

MEC1 MFG1 MIS1 MKT1 NUR1 PDN1 PM1

Property & Estate Management Purchasing Quality Control Research and Development Religious Services Retiree Security Services Teaching (In school) Teaching (others) Transportation Service Unemployed Others

PPT1 PUR1 QTY1 RD1 REG1 RET1 SEC1 TEA1 TEA2 TRA1 UNEM ZZZ

Year 2008

Important Instructions a) An application fee of S$42.80 (inclusive of 7% GST) is charged for each application. Each applicant should only submit one application form. b) All applicants (including Citizens and Permanent Residents of Singapore) must submit a copy of personal identification (e.g., Identity Card, Foreign ID Card, Passport). Non-Singaporean must also submit a copy of valid work-permit/employment pass/dependent pass. c) Certificates and detailed result transcripts of academic qualifications must be attached to this application form. d) All applications with incomplete information and/or not accompanied by copies of supporting documents, photograph and application fee will NOT be considered. e) All educational certificates, result transcripts and identification documents (eg. NRIC) must be certified by UniSIM. Please bring your original documents and photocopies for verification at SIM University, 461 Clementi Road, Student Recruitment Department, Level 2. Educational certificates and transcripts may also be certified true copies by the awarding institutions (eg. Polytechnic). f)

Kindly note that you will be considered for admission to UniSIM if you meet our minimum eligibility criteria. UniSIM reserves the right to accept or reject an application.

g) For more details, please refer to our website http://www.unisim.edu.sg, under the “Admissions” page.

9

How did you first learn about UniSIM?

Advertisements

Exhibitions

Mailers

On-Line

Please tick
ONE box only:

Bus Advertisements

LianHe ZaoBao

Magazines

MRT Advertisements

My Paper

Business Times

Radio Advertisements

The Straits Times

TODAY

TV Advertisements

Career Fair/Postgraduate Fair/Other Local Exhibitions

Overseas Exhibition

UniSIM/SIM Open House

Talks / Seminars

Direct Mailers

Mailers through MOE Schools

Mailers through tertiary institutions NTUC/SAFRA/HomeTeamNS/at-sunrice Website

Internet UniSIM/SIM Website SIM Directory

Today’s Manager

Publications Word of Mouth

Polytechnic Publications Friends/Family Members

UniSIM/SIM Graduates

Colleagues / Employers

UniSIM/SIM Students

10 Is UniSIM your first choice?

You may select more than one.

a) If Yes, please tick
the reason(s) for your choice: Accessibility

Credible lecturers

Facilities & resources

Flexible & independent learning

Local university

Programme offering

Quality degree

Reputation of UniSIM

Recognition by employers

Recommendation from friends/colleagues/family members

University for adult learners

Others (Specify):

b) If No, why? Please tick
the reason(s): I have also applied for admission with other local universities I have also applied for admission with other educational institutions I prefer a degree awarded by an overseas university UniSIM does not have my first choice of study Others (Specify):

Year 2008

11 Applicant’s Checklist Please ensure that items 1 to 3 are “Certified True Copy” and are attached to this application form. Supporting documents that are not certified true copy will mean that your admission application will not be considered. 1)

1 copy of ALL educational qualification certificates attained (including GCE ‘O’ level qualification)

2)

1 copy of detailed result transcript

3)

1 copy of personal identification document (e.g., Identity Card, Foreign ID card, Passport, Employment Pass)

4)

1 copy of letter of employment signed by your HR/immediate supervisor, or a copy of your latest computerised payslip

5)

Programme/Course syllabus of the qualification(s) which you want to be considered for Credit Exemption

6)

1 recent colour passport-sized photograph

7)

Application Fee (non-refundable) made payable to: “SIM University”

8)

I have asked my HR/immediate supervisor to verify the SIM Corporate Membership status (if applicable) (Section 8b)

9)

For company sponsored applicants: I have asked my HR to endorse my application form (Section 8a)

12 Applicant’s Declaration I certify that all information given by me in this application is true and correct. I understand that any misrepresentation or omission is sufficient grounds for rejecting my application. I also understand that SIM University reserves the right to cancel my student registration in the event of a false declaration. I understand that SIM University may obtain or verify my academic results from the Singapore Ministry of Education or my polytechnic. I hereby agree to abide by all regulations and procedures laid down by SIM University if I am successfully registered as its student. I hereby declare my consent to have my particulars made available to my tutors and lecturers.

Declaration on Government Subsidy

(Please tick
one of the following):

 I hereby confirm and declare that I had previously received a government-subsidised university education.  I hereby confirm and declare that I have not previously received any subsidies from the Singapore government in relation to my university education (whether undertaken on a full or part time basis). I acknowledge and fully understand that a false declaration may result in the rejection of my application or termination of my studies at SIM University, and/or other legal action being taken against me under the applicable laws.

Signature of Applicant

Date

Year 2008