Short Course Enrollment Form

Section 1: Personal Information 个人资料

Name 姓名*:

Age 年龄*:

Marital Status婚姻状况:

Single 单身Married 已婚Divorced 离婚

Gender 性别:

Male 男Female女

NRIC 身份证号码*:

Email 电邮地址*:

Mailing Address通讯地址*:

Handphone No.手机电话*:

Home phone No.住家电话*:

SECTION 2: ACADEMIC QUALIFICATION 学历

Please list all School / College / Qualifications that you have taken. 请选择您的学历资格和列出您所读的学校/学院*:

Please list all your working experience. 请列出您的工作经验:

SECTION 3: EMERGENCY CONTACT 紧急联络

Name 姓名*:

Relationship 关系*:

Handphone No. 手机电话*:

Home Phone No. 住家电话*:

Do you have any disability / serious illness which requires our attention? 你有否残疾/疾病？*:

Yes 是No 否

If yes, please indicate type of disability / serious illness 如果有的话，请注明残疾/疾病:

SECTION 4 : Documents to be submitted 要提交的文件 (each file size attached not exceed 1mb 随附文件大小不可超过1mb)

Certified copy of all relevant academic qualifications / examinations 学历资格 / 考试文凭副本 (file size not exceed 1mb):

Identity Card Copy身份证副本 (file size not exceed 1mb):

Passport size photos 护照尺寸照片 (file size not exceed 1mb):

SECTION 5 : Others 其他

Declaration 声明*:

I hereby declare that the information provided and documents submitted in connection with this application are true and correct. 本人谨此声明，所提供的资料和提交的文件是真实及正确。

Short Course Enrollment Form