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APPLICATION FOR MOE BURSARY & CDC/CCC-‐ARTS INSTITUTION BURSARY Checklist / Documents required for application (please ensure that all required documents are submitted this application) Please organise and submit your application in this sequence. Please þ tick items submitted : Photocopy of front & back of your NRIC and all NRIC of declared family members / household members ; Photocopy of siblings’ school concession cards or matriculation cards ; Proof of family total income (latest payslips, IR8A Form & CPF statements). If, for valid reasons, these documents are unavailable, please submit a completed income declaration form ; Photocopy of your Letter of Offer for new students joining the August 2014 intake ; Photocopy of death, separation or divorced certificates (if applicable) ; The monthly financial support from divorced / separate parent or spouse such as alimony and contributions to support children / household (if applicable) ; Any other supporting documentation that might support your case eg. medical reports;        Applicants only need to submit one application and will be automatically considered for both the MOE Bursary and the CDC / CCC Bursary. Applicants need not choose which bursary they wish to apply for and will be awarded either the MOE or CDC Bursary based on the per capita income (PCI) criteria. Name of Student (according to NRIC ) : NRIC No : Address : Student No: Postal Code : Level :  1  2  3 Institution : LASALLE College of the Arts Course : Diploma /BA (Hons)* in __________________________________________________________________ *Please delete where applicable. Please þ tick
NOTES FOR APPLICATION OF a)MOE BURSARY b)CDC/CCC-‐ARTS INSTITUTION BURSARY FOR 2014 a) MOE Bursary : The MOE Bursary is funded by the Singapore Government’s Ministry of Education (MOE) and provides financial aid to students from the lower to middle income groups. b) CDC/CCC Bursary : The CDC/CCC Arts Institution Bursary is co-‐funded by the Government, the Community Development Council (CDC) & the Citizens’ Consultative Committee (CCC). This scheme provides financial assistance to all Singaporean students pursuing art education at the Diploma or BA (Hons) level in Singapore. Eligibility Full-‐time diploma or BA (Hons) students who meet the following criteria may apply : a. Singapore citizens; b. Full-‐time Diploma or BA (Hons) studies on MOE Tuition Grant ; c. Applicants must not be holding the MOE Bursary & the CDC/CCC Bursary concurrently ; d. Students holding other scholarships or bursaries awarded by LASALLE may apply for an additional bursary by the CDC/CCC, if they are assessed to be in need for financial aid. However, students should not be in receipt of any other scholarships/ bursaries/study grants in the same period ; Application Procedure Application procedure is as follows: a. Complete the application form and submit to LASALLE, Division of Student Administration, Block E Level 2 with all required documents (please refer to checklist at the top of the application form) ; b. All submissions to reach the Division of Student Administration, Block E Level 2 before Friday, 17 October 2014, 5pm ; c. Late or incomplete submissions will not be considered ; d. Please inform the Division of Student Administration if you have any change in address in advance ; All information on income must be accompanied by latest payslips, CPF statements and IR8A /income tax statements, NRIC. If, for valid reasons, the latest payslips are not available, please submit a completed income declaration form & a copy of CPF statement for the previous 12 months as evidence. If employed, state occupation. Otherwise, state unemployed, housewife, deceased, divorced, separated or performing NS. Submission of this form does not guarantee any award of bursary. Page 1 of 4 MOE & CDC / CCC Bursary (October 2014) Gross Per Capita Income (PCI) The gross monthly per capita income is computed based on the total income of immediate and non-‐immediate family members over the total number of immediate and non-‐immediate family members, where •
Immediate family members include spouse, parents and all children who may or may not be living together with the student. Divorced/separated parent or spouse may be excluded from the headcount. •
Non-‐immediate family members include grandparents, siblings, spouses of siblings, siblings of parents, and any other relatives who are living together with the student. •
Income = gross (i.e. including employee’s CPF contribution) income contributions from all immediate and non-‐immediate family members from self employment, business or salaried employment (which includes basic salary, allowances, overtime, etc) as well as other sources of income (e.g rent). If bonuses are declared, it should be computed as one twelfth of the annual wage supplements and bonuses received in the last twelve months. The monthly financial support from divorced/separated parent or spouse such as alimony and contributions to support children/household should also be included. Payments in kind, reimbursement for transport and other expenses and National Service (NS) allowance earned by NS men are excluded. •
Immediate family members include parents and siblings living with the applicant ; Divorced / separated parents or spouse maybe excluded from the headcount ; •
Non-‐immediate family members include grandparents, siblings’ spouses, siblings’ children and any other relatives who are living with the applicant ; Value of Award Financial Assistance Per Capita Income (PCI) Value Per AY (Diploma) Value Per AY (BA Hons) S$0 – S$1,400 S$1,500 S$2,600 MOE Bursary S$1,401 – S$1,900 S$750 S$1,300 CDC / CCC Bursary S$0 – S$950 S$2,000 S$3,600 Notification of Results a) MOE Bursary : Successful applicants will be notified via the College email. Applicants with outstanding fees will have their bursary credited directly into their LASALLE fee account. The student will still be liable for any balance of the fees ; Applicants without outstanding fees will have a cheque made out to them. b) CDC / CCC Bursary : Successful applicants will be notified by the People’s Association via letter. Successful applicants are required to attend a presentation ceremony organised by the People’s Association (PA). ** Applicants are reminded that the processing time for either bursary may take up to between 8 – 12 weeks from the application deadline. Others Forms submitted by post or email will not be entertained. Incomplete or late applications will also not be considered. Awards given will be withdrawn if any information provided is falsely declared or incomplete. The decision made by the College is final and the College will not enter into any correspondence on the reasons for the decision. LASALLE may recover the MOE or CDC/CCC Bursary if (a) students withdraw from the course voluntarily within the same year of award, or (b) are in receipt of other bursaries, scholarships and/or study grants. Page 2 of 4 MOE & CDC / CCC Bursary (October 2014) Names of immediate family members Age Marital Status Relationship to applicant Occupation (3)
Monthly gross income from all sources (e.g. salary, rent & CPF) 1. Father 2. Mother 3. Sibling 4. Sibling 5. Sibling 6. Sibling 7. Monthly gross income from all sources (e.g. salary, rent & CPF) 8. Names of non-‐immediate family members living in the same household Marital Status Age Relationship to applicant (3)
Occupation 1. 2. 3. 4. Total S$ Per Capita Income S$ Are you currently receiving any financial assistance from LASALLE ? :
 Yes  No Please þ tick If yes, please provide name of financial assistance & year received : ___________________________Year : ____________ (eg. Tan Chay Bing Bursary or LASALLE Bursary or Future Leader Scholarship) Have you been awarded Yayasan Medaki’s Tertiary Tuition Fee Subsidy :
 Yes  No Please þ tick If yes, please indicate subsidy % & month/year received : 50% or 75% or 100% * Month/Year : ____________ * Please delete where applicable. Please indicate below the name(s) of your sibling(s) who are in receipt of the CDC/CCC-‐Arts Institution Bursary 2013 or who is/are applying for the CDC/CCC-‐Arts Institution Bursary in 2014. Name of Sibling : _________________________________________________ NRIC No : ______________________ Name of Sibling : _________________________________________________ NRIC No : ______________________ Name of Sibling : _________________________________________________ NRIC No : ______________________ Declaration I declare that I am/am not* in receipt of any other Bursary/Scholarship/Study Grant and the information stated in this application and the attachments are true to the best of my knowledge and belief, and I have not wilfully suppressed any material facts. I understand that the decision on any award is final and reserves the right not to disclose its reasons for approving and disapproving an application. _______________________________ _______________________________ Handphone / Telephone Signature & Date * Please delete where applicable Page 3 of 4 MOE & CDC / CCC Bursary (October 2014) Income Declaration Form This form is for use by family members or relatives living in the same household who are either self-‐employed or unemployed. • For a family member or relative who is self-‐employed, this form is only to be completed if he/she is unable to provide his/her payslip ; • For a family member or relative who is unemployed (including housewife / retiree) ; • One declaration form per family member or relative. Please make more copies if needed. I, ______________________________________________ , of NRIC Number, _________________ hereby declare that Please þ tick where applicable :
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I am self-‐employed and have no payslip. I earn S$____________ per month working as
_____________________. (Please produce latest Income Tax Statement/IR8A Form & CPF Statement* as evidence of self employment.)
(Type of Job) I work on a part-‐time/free-‐lance basis and have no payslip. I earn S$________ per month working as _________________________ (Please produce latest CFP statement* as evidence of part-‐time/free-‐lance employment.) (Type of Job) ☐
I am currently unemployed. (Please produce latest CFP statement* as evidence of non-‐employment.) ☐
I am currently unemployed but I have income from renting out a room in my flat. (Please produce latest CFP statement* as ☐
I am a housewife. (Please produce latest CFP statement* as evidence of non-‐employment.)
evidence of non-‐employment & copy of rental agreement.) ☐
I am a retiree. (Please produce evidence of retirement from full-‐time employment and/or latest CPF statement* as evidence of non-‐employment.)
I declare to the best of my knowledge, that the particulars above are true and correct. If there is a deliberate false declaration of my financial status on this form, the College has the right to withhold the disbursement of bursaries / scholarships to the applicant. __________________________________________
Signature & Date __________________________________________
Relationship to Applicant ____________________________________________
Name of Bursary / Scholarship Applicant *Note : 1) CPF members with SingPass can obtain their CPF Contrubition and Transaction History Statement from the CPF Board website a t www.cpf.gov.sg 2) Please approach CPF branches or Community Centres (CC) in person with NRIC to obtain SingPass or call CPF hotline at 1800 – 227 1188. Page 4 of 4 MOE & CDC / CCC Bursary (October 2014)