PRIVATE & CONFIDENTIAL
APPLICATION FORM
All information in this form will be kept confidential and used
solely for the purpose of completing the course application.
个人资料
PERSONAL DETAILS (USE BLOCK LETTERS)
1.
2.
4.
6.
8.
Name in NRIC/passport
英文姓名
Name in Chinese
华文姓名
Country of Birth 出生国家
Date of Birth 出生日期
3.
5.
日
日
月
月
年
DDMMYY format
NRIC/Passport No
身份证/护照号码
For international Students Only
Type of Singapore Pass currently held,
10 Employment pass
‘S’ Pass
Social Visit Pass
N.A
Country of Issue of Travel
Province/State
12 Document


证件类型


RESIDENTIAL ADDRESS IN SINGAPORE
Address
住址
州/省的出生
年
7.
Nationality
国籍
Age 年龄


女
Please attach
2 recent passport
size
photographs


单身
已婚
婚姻状况
Single
Married
11
Passport
Date
发行日期
DDMMYY format
日日
月月年年
13
Issue
护照
Passport
Expire Date
护照限期
请附上两张
个人近照
DDMMYY format
日
日月
月年年
本地住址
15.
电邮
18.
PERMANENT ADDRESS IN HOME COUNTRY
邮区
Mobile No. 手机号码
Tel. No. 电话号码
Postal Code
固定地址(For international Students only)
住址
20. Country 国家
22. Email 电邮
Fax 传真号
24.
码
NEXT OF KIN 近亲 (for emergency contact 紧急联系)
26. Name 姓名
27.
19.
Male
Female
Marital Status
16.
Email
男
性别
9.
14.
17.
Gender
Address
21.
23.
25.
Relationship
邮区
Tel No. 电话号码
Mobile No. 手机号码
Postal Code
关系
28.
+
+
Tel No.
电话号码
学历录,请附上相关文件(Please attached certified copies of qualification certificates and other official transcripts)
29. Highest Qualification Attained 最高学历
Name of school 学校名称
Qualification Awarded 资格授予
Country 国家
From (MM/YYYY) 从
To (MM/YYYY) 至
ACADEMIC BACKGROUND
30. EMPLOYMENT HISTORY
Employer/ Company Name
雇主/ 公司名字
ADM-001 v8.3
工作经验
(Please attach separate sheet if space is insufficient
Position Held
职位
Country
国家
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如果位置不足，请附加在白纸上)
Period of Employment
From (MM/YYYY)
工作年限从
Period of Employment
To (MM/YYYY)
工作年限至
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COURSE PREFERENCE
课程选项
31. 主修
32.
Proposed Course & Major
3
3 .
I would like to start the course
我想开始上课:
Full Time
4
Year 201___
3 .

Part Time

Month of ________________________
35. From which source did you first learn about our instituition or programme that you are applying for?
你是从什么渠道了解我们的学校或你所申请的课程?
 [ ] Website 网站

 [ ] Brochure 课程手册

展览
[
] Exhibitions
[
] Friends / Relatives
朋友/亲属


代理
[
] Agent/ EC
[
] Others: ____________________
Payment Methods
Please do not pay any cash to PIC Agent/s or Staff. Student must pay the Application Fees of $500/- directly to Portman International College
Pte Ltd UOB operational Account. The account information are as follows:
For Application Fee of $500/-, please make payment through one of the following methods:
Via telegraphic transfer, to be credited into
Bank Name: United Oversea Bank Limited, Singapore
Branch: Bukit Merah Branch
Address: 80 Raffles Place UOB Plaza 1. Singapore 048624
Account Name: Portman International College Private Limited
Account Number: 3933017573
Bank Code: 7375
Branch Code: 437
Swift Code: UOVBSGSG
Or
Via Cashier’s Order, Bank Draft or Cheque, kindly address it to Portman International College Private Limited
Important Notice
The above payment method is NOT meant for payment of MANDATORY FEES (Course Fees, Student Medical Insurance
Fee, ICA Application Fee (for the 1st Application), Bank Transaction Fee for DBS Escrow Fee)
These mandatory fees MUST be escrowed into Portman International College Pte Ltd Escrow Account. Invoice which will be
issued when a student is accepted will state the payment methods for these mandatory fees.
Parents and/or student may call our front office at 65-63762996 should there be any clarification needed for these different
payment methods.
33. DECLARATION
声明
□ I declare that the information given in this application is accurate and complete.
□ If my application is accepted, I agree to abide by the school’s regulations and to ensure prompt payment of
fees for which I am liable.
□ This application is not valid unless signed and dated.
我声明以上资料全部正确
声明以上资料全部正确.
以上资料全部正确. 一旦申请通过,
一旦申请通过,我将遵守校规以及保证定时缴付学费
我将遵守校规以及保证定时缴付学费.
校规以及保证定时缴付学费.这份申请书须要签名和写下日期才生效.
这份申请书须要签名和写下日期才生效.
------------------------------------------------------------------------------------------------Signature of applicant
:
签名
-------------------------------------------------------------------------Date
:
(Parent/Guardian if applicant is below 18 years old)
日期
All information in this form will be kept confidential and used solely for the purpose of completing the course submission.
这本表格中的所有信息将保密，
本表格中的所有信息将保密，并只用于完成课程提交用途。
并只用于完成课程提交用途。
•
•
All accompanying documents must either be original documents or certified true copies of the original documents. If
documents are not in English, notarized official translations must be included.
Incomplete application form will not be processed.
请将表格寄还到
Please return to
Portman International College Private Limited
168 Jalan Bukit Merah Connection One Tower 3 #04-07A/B Singapore 150168 Tel: 65-63762996 Fax: 65-62713147 Email: [email protected]
ADM-001 v8.3
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20130901