SAMLING SCHOLARSHIP APPLICATION FORM

Attach Recent Passport-sized Photograph here

INSTRUCTIONS
1. 2. 3. 4. 5. 6. Read through the criteria and form carefully before attempting to complete. Complete and sign this form in own handwriting using English and return with 1 recent passport-sized photograph. State N/A at those sections that not applicable to you. Close sections with * not applicable to you. If space of this form is insufficient, please attach an addendum. Arrange and attach documents according to the following sequence. University/ College/ Polytechnic Acceptance Letter Applicants Identity Card Applicants Birth Certificate SPM/ SPVM/ O Level/ UEC Transcript STPM/ A Level/ Matriculation/ Pre-U/ Diploma Transcript and Certificate Parents/ Guardians Proof of income Parents/ Guardians Identity Card or Death Certificate and Pension Card Applicants Saving Bank Book (first page only with saving account number) All duplicate copy of above documents must be certified true copy. The originals should be brought to a subsequent interview. Post the completed application to Group Human Resource Department, PO Box 2919, 93756 Kuching, Sarawak.

7. 8.

CRITERIA FOR APPLICATION

1. 2. 3. 4. 5. Malaysian citizens only. Students with excellent academic results seeking admission to or currently enrolled in a local university/ college/ polytechnic for full-time first degree or diploma course. Must not be current recipients of scholarships awarded by other organisations. Possess a dynamic personality, excellent communication skills and hold leadership positions in extra-curricular activities. Keen to serve in Samling Group for a specified period upon graduation.

PART I

PERSONAL PARTICULAR
Name in Chinese (if Chinese applicant): Postal Address:

Name (as shown in NRIC): Permanent Home Address:

Postcode: City & State: NRIC No.: Home Tel. No.: Marital Status:

Postcode: City & State: Date & Place of Birth: H/p No.: Citizenship:

Email Add.: Race:

PART II

COURSE DETAIL
University: Commencement Date (mm/yy): Other Fees: RM Transportation: RM Campus: Completion Date (mm/yy): Accommodation: RM Other Expenditure: RM

Course Enrolled: Course Duration: Tuition Fee: RM Ration: RM

PART III

GUARDIAN & PARRENTS DETAIL

Mothers Name: NRIC/ Passport* No.: Marital Status: Age & Citizenship: Home Add.:

Father/ Guardians* Name: NRIC/ Passport* No.: Marital Status: Age & Citizenship: Home Add.:

Postcode: City & State: Home Tel. No.: H/p No.: Occupation: Gross Monthly Income: Employment Status: Retired Full-time Part-time Own Business Name and Add. of Employer/ Own Business (If
retired, state name and address of previous employer/ own business.)

Postcode: City & State: Home Tel. No.: H/p No.: Occupation: Gross Monthly Income: Employment Status: Retired Full-time Part-time Own Business Name and Add. of Employer/ Own Business (If
retired, state name and address of previous employer/ own business.)

Office Tel. No.:

Office Tel. No.:

PART IV
Name

SIBLING PARTICULARS
NRIC No. Marital Status No. of Children
(if any)

Occupation (If studying, state status & name of school/ employer.)

Tel. No./ H/p No.

Gross Monthly Income

PART V
Qualification Standard

ACADEMIC RECORDS & EXTRA-CURRICULAR ACHIEVEMENTS

SPM/ SPVM/ O Level/ UEC* STPM/ A Level/ Matriculation/ Pre-U/ Diploma* University/ College/ Polytechnic Examination Results*

Name of School/ College/ Polytechnic/ University Commencement Year Completed Year Overall Grade/ Result Subjects & Grades (list
down)

Co-curricular Achievements (list down

activity with position level and award/prize)

PART VI
Name of Loan or Scholarship

FINANCIAL ASSISTANCE
Name of Organisation Year Received Amount per annum

PART VII
Name: Home Add.:

REFERENCE (Provide two referees who are known to you and your family for a period not less than 3
years. At least one should be competent to give an assessment of your school/academic life.)

Name: Home Add.:

Postcode: City & State: Home Tel. No.: H/p No.: Occupation: No. of years Known: Relationship to Applicant:

Postcode: City & State: Home Tel. No.: H/p No.: Occupation: No. of years Known: Relationship to Applicant:

PART VIII

OTHER INFORMATION (Other information to support your application e.g. why parents
cannot afford to sponsor your study, why we should offer you)

PART VIII

DECLARATION

I hereby declare that the information given by me in this application are true, complete and correct to the best of my knowledge and belief. I understand that any false statements or withholding of any relevant information may provide grounds for the withdrawal of any offer.

___________________________ Name of Applicant

_______________________ Signature of Applicant

______________________ Date of Application