COURSE applying for: FULL NAME AS IN PASSPORT: Surname/Family name: Given Names: Sex Gender: Date of birth: Place of birth: Birth Certificate number: Marital status: Race: Nationality: Religion: Occupation: Passport number: Passport issued by: Passport issued date: Passport expiry date: At this time are you presently physically in Singapore? Disembarkation/Embarkation WHITE CARD Barcode number: Date of entering into Singapore: Number of Days allowed to stay in Singapore? Date of expiry of Visa: Do you need extension of Visa / SVP? Phone numbers: Home Mobile Office Overseas address (in last 5 years) Singapore address: Do you have PROOF BY DOCUMENTS that you or your parents or siblings have more than S$10,000 IN SAVINGS OR FIXED DEPOSITS & they are willing to support your education in Singapore e.g. Bank Statements, Employment Letters, P/L statements,etc

1. ELEMENTARY EDUCATION Name of School attended: Language of instruction: From ddmmyy: To ddmmyy: Country/location of School: Highest Education Title attained: Certificate number: Note: Certificate & transcript details required 2. SECONDARY EDUCATION (a) Name of School attended: Language of instruction: From ddmmyy: To ddmmyy: Country/location of School: Highest Education Title attained (b) Name of School attended: Language of Instruction: From ddmmyy: To ddmdmyy: Country/Location of School: Highest Educational Title attained: Note: Certificate & transcript details required TERTIERY EDUCATION Name of School/College/U attended: Language of instruction: From ddmmyy: To ddmmyy: Country/location of School/College/U: Highest Education title attained Note: Certificate & transcript details required Other Qualification/Skills: (Pls list below)

(a) Name of Company: Location of company: Period worked: From ddmmyy To ddmmyy: Job title/ Nature of duties Salary per month: (b) Name of Company: Location of Country of Company: Period worked: From ddmmyy To: ddmmyy: Job title/Nature of duties Salary per month: (c) Name of Company: Location of company: Period worked: Fr:ddmmyy To ddmmyy: Job title/Nature of duties Salary per month: (d) Name of company: Location of Country of Co: Period worked: Fr ddmmyy To: ddmmyy Job title/Nature of duties Salary per month: REPEAT IF NECESSARY

(a)Father's name: Father's date of birth: Nationality of father: SC/SPR/EP/SP/WP number: Step-parent's name: Step-parent's date of birth: Nationality of Step-parent: SC/SPR/EP/SP/WP number: 2. Mother's name: Mother's's date of birth: Nationality of mother: SC/SPR/EP/SP/WP number: 3. Spouse's name: Spouse's date of birth: Nationality of spouse: SC/SPR/EP/SP/WP number: 4. (a) Sibling's name: Sibling's date of birth: Nationality of sibling: SC/SPR/EP/SP/WP/ number: 4.(b) Sibling's name: Sibling's date of birth: Sex of sibling: Nationality of sibling: SC/SPR/EP/SP/WP number: REPEAT IF NECESSARY

I the applicant certify that the above information furnished by me is true and correct to the best of my knowledge. I understand that misrepresentation or falsification of information is sufficient ground for rejecting or rescinding my application. If accepted as a student, I will comply with all conditions and regulations of the School and I ensure payment of all relevant fees and charges. Signed by the Applicant........................................... Countersigned by parent/guardian if under 21 ........................................................................

Please attach supportive documents below

Passport page with photo
Recent p/p size photo 400 x 514 pixel
1st Highest Edu Cert
Marks Result Transcript
2nd Highest Edu Cert
Marks Result Transcript
Work Exp. Cert / Testimonial (1)
Work Exp. Cert / Testimonial (2)
Parent's marriage certificate
Bank Statement
Student's Birth cert
Others

Email address is compulsory

Steve Say  史 - Filmo, 1 Sophia Road #02-16 Peace Centre Singapore 228149