SID: ____________

Full Time/International Student Application Form / (Private & Confidential)

SECTION 1: APPLICATION DETAILS
New Application Transfer Name of Current School/PEI ___________________________________________ Student Pass No. __________________________________________________

SECTION 2 : STUDENTS PARTICULARS

Name of Student Date of Birth (DD/MM/YY) // NRIC/Passport No. /FIN No. //FIN Passport Expiry Date Nationality Singaporean PR : ____________________________________ ___________________________________ ________________________ (M / F ) ________________________

Please attach 2 passport-sized photographs

Others ___________________ (Please specify ) Home Address : ____________________________________________________________________ ____________________________________________________________________ Contact HOME ________________________ MOBILE ________________________

EMAIL ADDRESS ________________________________________________ QQ ______________________________________ Have you ever studied in Singapore? Yes No

If yes, please state from ___________________ (MM/YYYY) to _____________________ (MM/YYYY) / / Period of study: ______________________ (MM/YYYY) / Name of School/PEI : _______________________________________________________________________

AD 106 V1.1 072013

Full-time Student Application Form

www.idy.edu.sg CPE Registration No.: 200403907H Validity: 10/02/2012-09/02/2016

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SID: ____________

Full Time/International Student Application Form / (Private & Confidential)

SECTION 3: COURSE (S) WHICH YOU WISH TO APPLY FOR
Preparatory Course for Admission to Singapore Government School Primary 2 Secondary 1 Primary 3 Secondary 2 Primary 4 Secondary 3 Primary 5 Preparatory Course for Singapore Cambridge General Certificate Examination GCE O Level O Preparatory Course for Singapore Cambridge General Certificate Examination GCE A Level A Cambridge English Language First Certificate in English (FCE) FCE Certificate in Advanced English (CAE) CAE Certificate of Proficiency in English (CPE) CPE International English Language Testing System (IELTS) IELTS SAT

SECTION 4: EDUCATION BACKGROUND

Name of School Qualification Awarded Country From (Month/Year) To (Month/Year)

SECTION 5: EMPLOYMENT HISTORY (IF APPLICABLE)

Name of Company Nature of Business Designation From (Month/Year) To (Month/Year)

AD 106 V1.1 072013

Full-time Student Application Form

www.idy.edu.sg CPE Registration No.: 200403907H Validity: 10/02/2012-09/02/2016

Page 2 of 5

SID: ____________

Full Time/International Student Application Form / (Private & Confidential)

SECTION 6: PARENT/GUARDIANS PA RTICULARS /
Preferred Contact Mother Father Guardian Guardian Name Mobile QQ: Office Home Email Company Designation NRIC/FIN/Passport No: Mobile QQ: Office

Father /Mother (Please delete ) Name Home Email Company Designation NRIC/FIN/Passport No:

SECTION 7: CHECKLIST
Completed ALL sections of this application form and duly signed by applicant Completed Pre-Course Counseling Form 1 original set of ICA Form 16 and NEW V36 completed in English and duly signed by the applicant 2 passport-sized photographs 1 photocopy of your original passport 1 photocopy of your original birth certificate Notarized and certified copies of your highest educational certificates and transcripts Proof of English Proficiency or IELTS or TOEFL score sheet (if applicable) Documentary proof of financial ability and p arents statement of monthly income (for visa-required countries) S$500 application fee (For international students who need to apply for a student pass) Application fee is nontransferable and non-refundable and payable to IDY Academy Pte Ltd
AD 106 V1.1 072013 Full-time Student Application Form www.idy.edu.sg CPE Registration No.: 200403907H Validity: 10/02/2012-09/02/2016

Page 3 of 5

SID: ____________

Full Time/International Student Application Form / (Private & Confidential)

S$200 application fee (PR, DP or Singaporean students) Application fee is non-transferable and non-refundable and payable to IDY Academy Pte Ltd All documents must be original, notarized and certified. If documents are not in English, official translations must be included.

SECTION 8: DECLARATION
Do you have any disability or medical condition that IDY Academy needs to be aware of? No Yes. Please specify: ______________________________________________________

I agree to authorize my portrait to IDY Academy for academic and marketing purposes. I agree to abide by the rules and regulations of IDY Academy. I accept that IDY Academy reserves the right to select and reject applications for course admission without any reason given. I confirm and declare that the information provided in this application is true and accurate. In the event any information is found to be incorrect or incomplete, IDY Academy reserves the right to withdraw any offer made, or to terminate my enrolment. I understand that IDY Academy is not liable to application of student pass being rejected by the Singapore Immigration & Checkpoint Authority (ICA) _______________________________________ Signature of Applicant ___________________________________ Date

AD 106 V1.1 072013

Full-time Student Application Form

www.idy.edu.sg CPE Registration No.: 200403907H Validity: 10/02/2012-09/02/2016

Page 4 of 5

SID: ____________

Full Time/International Student Application Form / (Private & Confidential)

FOR OFFICE USE ONLY
1. With / Without* Agent Agents Code:_______________ Agents Name: ________________

2. Meet Minimal English Entry Requirements: Yes / No* 3. Meet Course Entry Requirements: Yes / No* 4. Admin Check for Documents Accuracy: Yes / No* Checked By: Name:________________ Signature: _________________ Date:__________________ 5. Academic Department Approval On Academic Entry Requirements Approved / Rejected* Reason For Rejection: _________________________________ Name:___________________ Signature: _____________________ Date:__________________ 6. Management Approval On Student Admission Approved / Rejected* Reason For Rejection: _________________________________ Name:_____________________ Signature: _____________________ Amount:_______________ Date:__________________ Cash/Cheque No.*_____________

7. Course Application Fee Paid: Yes / No*

* Delete where appropriate

AD 106 V1.1 072013

Full-time Student Application Form

www.idy.edu.sg CPE Registration No.: 200403907H Validity: 10/02/2012-09/02/2016

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