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National University of Singapore Financial Aid & Scholarships Application Summary Document (ASD)

Your online application was received on Name: Student No. / Application No.: Course & Year of Study: Academic Year and Semester: Nationality: Contact No. & Email: Scheme applied for:
24-Feb-2011 05:21:52 PM
MISS NGUYEN THI KIM LONG U098871E

2011/2012, 1 VIETNAM 91773210(HP), u0908871@nus.edu.sg


Financial Aid & Scholarship

1. Please save and PRINT this set of documents and submit it with the relevant supporting document(s) to the Office of Financial Aid within two weeks from the online submission date. Supporting Documents Checklist (A) All Financial Aid applicants are to submit a photocopied version of the following documents, where applicable. Only original copies of Form A1, A2 and B are acceptable. Document: 1. Identification documents stating nationality and existing home address. If any of the information is not indicated, certified documents by the local authorities stating both information are required. 2. Latest salary slip or latest IR8A Form / income tax assessment stating income for the year 3. Declaration Form A1 4. Letter from employer stating gross monthly salary 5. Retrenchment letter stating retrenchment benefits 6. CPF/EPF withdrawal statement and/or pension document (if applicable) 7. Last drawn salary slip or letter from former employer and Declaration Form A2 8. Insurance claims 9. Medical report from a certified general practitioner / specialist doctor and latest month medical bill(s) 10. Death certificate 11. Notice of bankruptcy 12. Divorce or separation deed and alimony documents Compulsory in respect of : All applicants and household members staying with applicants All employed (including self-employed) family member(s) Self-employed family member(s) Employed (excluding self-employed) family member(s) who are not able to produce documents in (2). Retrenched family member(s) Retired family member(s) Unemployed family member(s) (excluding housewife and student) Family member(s) who have received insurance payment Family member(s) suffering from any of the following: - Critical or terminal illness - Physical or mental disability Deceased immediate family member(s) Family member(s) declaring bankruptcy Applicants parents who are divorced or separated

(B) In addition to the above, applicants who reported no (zero) family income will need to submit Declaration Form B (Expense Worksheet) together with a photocopied version of the following documents, where applicable: Document: 1. Latest utilities and phone bills 2. Vehicle loan agreement or payment advice (if applicable) 3. Latest insurance premium payment advice (if applicable) 4. Latest credit card bill (if applicable) (C) Applicants for Donated Scholarships are only required to submit the ASD and supporting documents upon request by the Office of Financial Aid. 2. Your application will NOT be considered if you do not submit the required document(s) on time. 3. You may submit your documents by hand/post to the Office of Financial Aid at:
Office of Financial Aid (within Office of Admissions) National University of Singapore, University Hall, Tan Chin Tuan Wing, Lower Ground, 21 Lower Kent Ridge Road, Singapore 119077 Operational Hours: Monday - Thursday: 8.30 am - 6.00 pm; Friday: 8.30 am 5.30 pm; Weekends & Public Holidays: Closed

NUS: Application for financial assistance- Family Members

Student Number: U098871E

2. FINANCIAL INFORMATION 2.1 Family members staying with applicant in home country. (Include siblings who are studying abroad) Family Member 1 Name: Highest Educational Level: Job Title Monthly Gross Income: Family Member 2 Name: Highest Educational Level: Job Title Monthly Gross Income: Family Member 3 Name: Highest Educational Level: Job Title Monthly Gross Income: Family Member 4 Name: Highest Educational Level: Job Title Monthly Gross Income: Family Member 5 Name: Highest Educational Level: Job Title Monthly Gross Income: Family Member 6 Name: Highest Educational Level: Age: Marital Status: Relationship: Employment Status: Age: Marital Status: Job Sector Currency: Relationship: Employment Status: Name of Co./School Last Drawn Salary date: Age: Marital Status: Job Sector Currency: Relationship: Employment Status: Name of Co./School Last Drawn Salary date:

NGUYEN SY PHAI College Certificate Q/C Inspector 4500000

Age: Marital Status: Job Sector Currency:

53 Married

Relationship: Employment Status:

Father Employed Lilama 45.1 28/02/2011

Architectural, Engineering & Technical Name Services of Co./School Vietnam Dong


Last Drawn Salary date:

LE THI VAN High School Certificate

Age: Marital Status: Job Sector

48 Married

Relationship: Employment Status: Name of Co./School

Mother Housewife Housewife

Currency:

Vietnam Dong

Last Drawn Salary date:

NGUYEN PHI DUNG College Certificate

Age: Marital Status: Job Sector

25 Single

Relationship: Employment Status: Name of Co./School

Brother Student University Of Technology

Currency:

Vietnam Dong

Last Drawn Salary date:

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NUS: Application for financial assistance- Family Members

Job Title Monthly Gross Income: Family Member 7 Name: Highest Educational Level: Job Title Monthly Gross Income:

Job Sector Currency:

Name of Co./School Last Drawn Salary date:

Age: Marital Status: Job Sector Currency:

Relationship: Employment Status: Name of Co./School Last Drawn Salary date:

2.2 Family members not staying with applicant in home country (include siblings who are married) Family Member 1 Name: Highest Educational Level: Job Title Monthly Contribution: Family Member 2 Name: Highest Educational Level: Job Title Monthly Contribution: Family Member 3 Name: Highest Educational Level: Job Title Monthly Contribution: Family Member 4 Name: Highest Educational Level: Job Title Monthly Contribution: Total: Age: Marital Status: Job Sector Currency: Relationship: Employment Status: Name of Co./School Last Drawn Salary date: Age: Marital Status: Job Sector Currency: Relationship: Employment Status: Name of Co./School Last Drawn Salary date: Age: Marital Status: Job Sector Currency: Relationship: Employment Status: Name of Co./School Last Drawn Salary date: Age: Marital Status: Job Sector Currency: Relationship: Employment Status: Name of Co./School Last Drawn Salary date:

4500000

2.3 a) b) c) d) Are you or any of your family members a bankrupt? (If Yes, please provide relevant documentation to prove the status) Are you or any of your family members suffering from any physical or mental disability? (If Yes, please provide relevant medical reports) Are you or any of your family members suffering from a terminal or critical illness? (If Yes, please provide relevant medical reports) Do you have any siblings studying in a polytechnic or university?  Yes Yes Yes Yes No No No No

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2.4. Summary of current family financial situation which explains your need for financial aid.
My father is the only breadwinner for my family and he has to try his best to cover all our living expenses. My brother and I feel like a big burden to him because our education fees cost a lot. Unfortunately living expenses have increased a lot today so it must be the pressure for my parents if I study abroad without any financial aids. Actually my father's salary is not a large amount even if I study in Vietnam so I have to apply for Financial Aid as soon as possible.

2.5 Explanation on how your family supports itself (applicable only to those with $0 income). [100 to 200 words].

6. Declaration I declare that the information stated in this application and the attachments are true to the best of my knowledge and I have not willfully suppressed or misrepresented any material fact.

I understand that any willful suppression of information will render me ineligible for consideration.

Date:

24-Feb-2011 05:21:52 PM

Note: Only sections 2 and 6 of the application form will appear in the ASD. Once an application is submitted, you will not be able to amend the submitted information in the application system.

Signature of Applicant

_________________ Signature of Applicant

_________________ Date
Date

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