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THE YAYASAN WAH SEONG SCHOLARSHIP AWARDS 2014
(For Local Public & Private Universities/Colleges only)

Type of Application
Please tick / the box
Public University/College 1
st
Degree
Private University/College Diploma


Complete ALL sections in BLOCK LETTERS:

1. PERSONAL DETAILS
(Married applicants to also fill in Item 10)

Full name:
NRIC No. / Race:
Date of Birth: e-mail:
Home Address:
State: Post code: Single/Married:
Correspondence Address (if different from above):

State: Post code:
Tel (Home): Tel (Mobile):



2. ACADEMIC HISTORY (Begin with most recent qualification)
(Current undergraduates also to fill in Item 3)

Qualifications Exam Year Subjects Grades/CGPA
STPM/Matriculation/
Foundation/Diploma*
(delete not applicable)




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SPM





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* Please attach another sheet, if required





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3. INFORMATION OF EDUCATION:
(Name of school previously attended by applicant)

Schools attended Year
commenced
Year
completed
Qualifications
obtained








4. EXTRA CURRICULAR ACTIVITIES
(Please provide information for the period from Form 4 onwards only)

No Year Position/Participation Activity/Society/Sports Level of participation
(School/ District/ State/
National)
1
2
3
4
5
6

(Please continue on another sheet, if required)

5. APPLICANT IS CURRENTLY AN UNDERGRADUATE STUDENT:
(This section is applicable to undergraduates only)

Name of institution/university:
Course of study:
Duration of course (years): Latest CGPA in semester/year:
Current year and stage of study:
Commencement date for current academic year:


6. FAMILY PARTICULARS

Name of Parents or
Guardian

NRIC No

Tel/hp No.
Date of
birth

Occupation
Monthly
Income
(RM)
(Father/Guardian name)

(Mother name)

TOTAL Monthly Income











3

Siblings


Name of Sibling
NRIC No or
Birth Cert No.
Date
of birth
Occupation/
Studying (Std/)
(Form/Tertiary)
Monthly
Income
(if any)





(Please continue on another sheet, if required)

7. ADMISSION GAINED* or APPLIED* FOR CURRENT ACADEMIC YEAR – 2014/2015

No Course Public or Private
University/College
Course Duration (Years)
1
2
3
4
5

(*delete where appropriate)

8. ANNUAL EXPENSES (estimate)


RM
Annual tuition fees
Other compulsory fees
Board and lodging
Transportation
Textbooks
Miscellaneous pocket expenses
TOTAL Annual Expenses


9. REFEREES
(Please do not select immediate family members or relations)


Full name:
NRIC No:
Occupation: Contact No:
Address/State/Post code:


Full name:
NRIC No:
Occupation: Contact No:
Address/State/Post code:





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10. STATEMENT OF PURPOSE
(Attach separate paper)

Write a statement indicating how the chosen course of study fits in with your career aspirations OR
outline reasons why you deserve this scholarship in not more than 200 words. (Attach separate paper)


11. MARRIED APPLICANT

Details of Spouse

Name of Spouse NRIC No. Age Occupation Monthly Income (RM)



Children

No. Name NRIC /Birth Cert. No. Age Studying(k’garten/std/form)





12. HOW DID YOU COME TO KNOW ABOUT THIS SCHOLARSHIP?
(Please select accordingly)
 Advertisement – Name of newspaper: _______________
 Website
 Friends
 School teachers
 Others (please specify)___________________________


13. TERMS AND CONDITIONS

 The scholarship award is for the pursuit of a full-time diploma/first degree program at
institutions of higher learning in local public or private universities/colleges in Malaysia.
 The value of each award is subject to the course taken and will not exceed RM9,000 per
academic year in public or private university/college. Each award will be for the minimum
period required to complete the course of study.
 The scholarship award will be reviewed annually subject to academic performance and other
terms and conditions stipulated.
 Successful candidates shall not at anytime during the course be in receipt of any other
scholarships, financial aid or award from other educational institutions or organizations
without the prior consent of YAYASAN WAH SEONG.
 The offer of award is subject to the candidates successfully gaining admission to the
universities/colleges for the current academic year.
 Successful candidates are required to sign a Scholarship Agreement and are deemed to be
aware of the terms and conditions of the scholarship award and the rules and regulations
governing the program.
 YAYASAN WAH SEONG reserves the right to amend/modify the terms and conditions of the
Scholarship award from time to time as deemed appropriate.








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14. DECLARATION

I hereby agree and consent to Yayasan Wah Seong (Yayasan) storing and processing my personal
data and the information given by me in the scholarship application form is correct and true to the best
of my knowledge. I hereby agree that Yayasan has the right to conduct any investigation against the
information provided by me in the scholarship application form. I fully understand and accept that, if at
any time after awarding the scholarship, it is found that a false declaration has been made on this form,
Yayasan has the absolute right to terminate my scholarship forthwith.

I have notified my family members (including my parents and siblings) of the contents of this
scholarship application form and I hereby confirm that my family members have consented to Yayasan
storing and processing their personal data given by me in this scholarship application form. I hereby
agree and consent to Yayasan storing and processing the personal data of my family members given
by me in this scholarship application form.



___________________ _______________
Signature of Applicant Date




Successful short-listed candidates must provide the following documents during the preliminary
interview.
 Copy of academic transcripts that have been certified as True copies by the schools or
university/college from where the candidate graduated,
 Letter of admission from the university or college, (if any)
 Any other documents that candidates wish to submit to strengthen their application including
copies of articles written, reports of volunteer work, extra curricular certificates etc.




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