Application for Admission (Undergraduate Programme)
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)
1
Choice of Programme
Choice
1
Programme Title (eg. BSc Business)
Intake (month/year)
st
2nd
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
Married
/
Date of Birth: 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.
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: ____________
No
Year 2008
4
Present Employment Details
Company Name: Company Address:
Postal Code
General Tel No:
6
Industry Code:
0 2 0 -
DID/Ext:
Fax:
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
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 Country
Taken at SIM/SIM-OUC
Mode of Study
Fr: Awarding Institution
Part-time
Yes
Full-time
No
mm/yyyy
To: Qualification Title
mm/yyyy
Name of Qualification & Awarding Institution
Country
Period of Study
Certificate Country
Taken at SIM/SIM-OUC
Mode of Study
Fr: Awarding Institution
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
Mode of Study
mm/yyyy
Name of Qualification & Awarding Institution
Country
Other Qualifications ++
Period of Study
Mode of Study Part-time
Fr: Awarding Institution
Country
mm/yyyy
Full-time
To: Qualification Title
mm/yyyy
“A” Level Qualification GCE ‘A’ Level (Singapore-Cambridge)
Number of ‘A’ level passes
Other GCE ‘A’ level equivalent (e.g., STPM, HSC, IB)
No. of passes ____________
Year of Award:
Number of ‘AO’ level 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
TOEFL; Year of award
(Total score:
: Test of Written English score ____________ )
IELTS
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
Transport, Storage & Communications Storage and Warehousing Travel Agencies
Manufacturing Transport Equipment (Shipbuilding/Repairing Marine Engineering/Offshore Rigs, Motor Vehicles, Motor Cycles, Bicycles & Aircrafts) Instrumentation Equipment, Photographic & Optical Goods Other Manufacturing Industries
317 399
Electricity, Gas & Water Gas Manufacture and Distribution
401
Construction Building Construction, Electrical Wiring & Installation, Plumbing
501
702 703
316
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
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) You may apply for a maximum of two programmes, but you would only be admitted to one programme. c) 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. d) Certificates and detailed result transcripts of academic qualifications must be attached to this application form. e) If you have attained academic qualification beyond GCE ‘A’ level, i.e., Diploma, Advanced/Higher Diploma or a Degree, you are eligible to be considered for Credit Exemption. See Section 11 of this application form. f)
All applications with incomplete information and/or not accompanied by copies of supporting documents, photograph and application fee will NOT be considered.
g) 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). h) 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. i)
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
Fairs / Seminars
Mailers
On-Line
Publications Word of Mouth
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 Internet
NTUC/SAFRA/HomeTeamNS/at-sunrice Website
UniSIM/SIM Website SIM Directory
Today’s Manager 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 Credit Exemption If you have attained academic qualification beyond GCE ‘A’ level, i.e., Diploma, Advanced/Higher Diploma or a Degree, you are eligible to be considered for Credit Exemption. Please tick one of the following: Yes, I wish to be considered for credit exemptions. No, I do not wish to be considered for credit exemption. PLEASE NOTE THAT IF YOU DO NOT APPLY FOR CREDIT EXEMPTION NOW, YOU CANNOT APPLY FOR IT AT A LATER DATE. In order for UniSIM to assess your previous qualification for Credit Exemption, please attach the programme syllabus and a copy of your academic transcript. Applications with incomplete information will NOT be considered. If you want an indication of whether your qualification(s) is eligible for any credit exemption, please refer to our website at www.unisim.edu.sg (under “View Credit Exemptions”). There is no application fee for the application of credit exemption; however, you have to pay a credit exemption fee upon acceptance of the credit exemption awarded.
12 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)
13 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