Oye Asfsgiaigiga

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NURSING / HEALTH SCIENCE SPONSORSHIP APPLICATION FORM
Mail To:

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a. b. c. ● ● ● ●

IMPORTANT APPLICATION NOTES
Please read the following instructions carefully. This application must be accompanied by copies of the documents listed in (c) below. The originals should NOT be forwarded but must be produced later. All information required must be supplied. If not applicable, write N.A. False particulars or wilful suppression of material facts will render you liable to disqualification. Please complete and submit the application form together with the following: One passport-sized photo Educational certificates Academic transcripts (for current students) ● Copy of NRIC / Passport ● Co Curricular Activities (CCA) records ● Educational institution medical report (if applicable)

Jurong Health Services Alexandra Hospital 378 Alexandra Road, Singapore 159964 Attention : Human Resource Scholarship & Sponsorship Unit

Letter of Acceptance from the relevant educational institution (if applicable)

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AWARD APPLYING FOR
Please indicate with (X) the award you are applying for. NURSING Sponsorship / Scholarship for Bachelor of Science (Nursing) Sponsorship for Diploma in Nursing Sponsorship for NITEC in Nursing HEALTH SCIENCE Scholarship for Degree in Health Science (indicate field of study) Health Science Sponsorship for Diploma in Diagnostic Radiography Health Science Sponsorship for Diploma in Physiotherapy Health Science Sponsorship for Diploma in Occupational Therapy Name of Institute: Field of Study: (please fill in if the field of study is not indicated on the left column) Year of study (as at application): Year of study (as at application): Course Commencement Date : Course Commencement Date : Name of Institute:

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PERSONAL PARTICULARS
*Please delete where appropriate. Full Name (Please underline family name) Name in Chinese Character (if any)

NRIC / Passport No:

*Colour of Singapore IC : Pink / Blue / Not