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ACADEMIC QUALIFICATION 学术资格
SPM/ O-Levels/ Equivalent	Grade/ Mark	STPM/ A-Level/ UEC/ Equivalent	Grade/ Mark	Other Qualifications	Grade/ Mark
Subjects		Subjects		Subjects

申请的学院/ 大学学院 ( 只限一间 〕 College/ University College applied	申请的课程 ( 只限选一个 〕 Course applied

DECLARATION BY APPLICANT 申请人申明
奖学金申请人必需获得校长/ 高级行政官员/ 课程主任的签名 The Scholarship Applicant is required to obtain an andorsement for this application from her/ his School Principal or Senior School Master or Programme Director.
姓名: Name:	职位: Designation:
签名: Signature:	学校印章: School Stamp:
你是否曾接收奖学金? have you been awarded any scholarship before?	有/ Yes 无/ No
如有，请提供奖学金赞助单位及奖金性质。 If "Yes", please provide name of the awarding body and the nature of the scholarship.
本人_______________________________________申明上述所提出的资料完全属实。若本人提供不正确或不完整的资料，"南洋商报大专奖学金"遴选委员会有权取消本人的申请资格。我也同意遵守所有的条规。 I__________________________________________ declare that the information provided by me in connection with this application is true and corrent. I understand and agree that < Nanyang Scholarship> Committee reserve the right to vary or reserve any decision regarding this application made on the basic of incorrect or incomplete information. I also agree to abide by all terms and conditions as stated.
申请人签名: Signature of Applicant:
申请人姓名: Name of Applicant:	日期: Date:
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