Samsung Malaysia Electronics (SME) Sdn. Bhd.

Samsung SMART Scholarship APPLICATION FORM

About Samsung
For more than 40 years, Samsung has been at the forefront of Innovation. Samsungs discoveries, inventions and breakthrough products have helped shape the history of digital evolution. Samsung Electronics is a global leader in technology, opening new possibilities for people everywhere. At Samsung, we follow a simple business philosophy: to devote our talent and technology to creating superior products and services that contribute to a better global society. As part of our Corporate Citizenship initiatives, we are now looking to groom young Malaysian talents by providing scholarship and opportunity to start a rewarding career with Samsung.

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About Samsung SMART Scholarship: The Samsung SMART Scholarship is an initiative by Samsung Malaysia Electronics to provide financial assistance to students in support of their education. Scholarship amount of RM 8,500 per annum will be offered to qualified students. Application is open to those who are offered undergraduate courses from selected local universities. Successful applicants will receive full amount of scholarships throughout their years of studies. Any balance, after deducting their tuition and exam fees, will be given to students to finance their living expenses. In addition, successful applicants will also receive a Samsung device. Important: Applicants must not be bonded to, or in receipt of any scholarship from any other companies or institutions. Successful applicants are required to dedicate a certain amount of hours towards participating in Samsungs Corporate Citizenship initiatives locally.

Advantages: Scholarship recipients will undergo a training opportunity as part of their practical training or internship should it be required by their field of study at Samsung. Scholarship recipients will receive a chance to participate in Samsungs Corporate Citizenship initiatives locally to impact the lives of the underprivileged. Scholarship recipients will receive a Samsung product to be used for their studies.

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SAMSUNG SMART SCHOLARSHIP APPLICATION FORM Eligibility criteria: Applicant must have obtained at least 3As in Sijil Tinggi Pelajaran Malaysia (STPM) or Minimum CGPA of 3.5 and above in Matriculation. Applicant must be a Malaysian citizen, not more than 23 years of age. Applicant must display strong leadership skills and active participation in extracurricular activities such as volunteering activities, societies, clubs, sports etc. Applicant must be a first year degree student in any of the following fields of study: o Marketing o Business Management/ Administration o Human Resource o Accounting / Finance / Commerce o Mass Communication / Public Relations/ Media Studies o Law o Information Technology Instructions:

Please attach recent photo

Please attach the following documents with completed application form: o A copy of Malaysian identification card o Certified true copies of examination certificates o Testimonials o Offer letter from the university o A copy of university identity card o Co-curriculum activities certificates o Parents income documents such as income tax form (Form J) or letter from employer o A passport size photo o Any other document that may support your application for scholarship Please refer to your Student Affairs Department and its website for more information. Only shortlisted students will be notified for interview. Incomplete application forms will be automatically disqualified. Applications that dont meet the eligibility criteria will be disqualified. Please return the application form together with the necessary documents as required above to your Student Affairs Department. Please ensure handwriting is legible, use BLOCK LETTERS.

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PERSONAL PARTICULARS Name per NRIC: ____________________________________________________________________________________________________ NRIC No: _________________________________________ Date of birth (dd/mm/yy): ___________________________________ Race: ____________________________ Gender: ______________________ Marital Status: _________________________________ Home Address: ____________________________________________________________________________________________________ ______________________________________________________________________________________________________________________ Postal Address: ____________________________________________________________________________________________________ ______________________________________________________________________________________________________________________ Tel. No. (House): ________________________________ (Mobile): ________________________________ E-mail: ______________________________________________________________________________________________________________ COURSE PARTICULARS Course of study: ____________________________________________________________________________________________________ Name of institution: _______________________________________________________________________________________________ Duration of Course: _______________ Commencement (mm/yy): ___________ Completion (mm/yy): ___________ Total tuition fees: ____________________ EDUCATION ACHIEVEMENTS Results of SPM Name of School/ College: Results of STPM Name of School/ College: Results of other pre-university examination (Certificate/ Matriculation Diploma) Name of School/ College:

From (mm/yy) Subject

To (mm/yy) Units/ Grade

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Total Units

Total Units

Total Units

EXTRA-CURRICULAR INVOLVEMENTS Activities/ Responsibilities

Awards/ Recognition / Achievements/ Key Learning

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IMMEDIATE FAMILY PARTICULARS Name Relationship Age Occupation Gross monthly income

FAMILY INCOME Fathers gross monthly income: _____________________________________________________________________________ Mothers gross monthly income: ____________________________________________________________________________ Other sources of income: ____________________________________________________________________________________ Assets owned: House: RM _____________________ Land: RM_____________________ Others: RM____________________ ADDITIONAL INFORMATION State any other relevant facts / information you may wish to advance in support of your application.

I hereby declare that I have read and fully understand the disqualification terms set forth in this application form and that the information given in this form and the documents attached are true in every respect. I have not wilfully suppressed any materials or facts that will be sufficient ground for disqualification. By submitting my particulars herein, I agree that I have given you my consent to the collection, use and/or disclosure of my personal information for the purpose of this application.

_________________________________________ Applicants signature

__________________________ Date

____________________________________ Name

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