13th SINO-SINGAPORE UNDERGRADUATE EXCHANGE PROGRAMME

22 MAY - 5JUNE 2016 (CHINA) & 17 – 31 JULY 2016 (SINGAPORE)

Instructions:

  • There are 3pages to this application form
  • Complete all pages and sections in CAPITAL LETTERS(except the essay section)Write N/A if an item is Not Applicable
  • Submission deadline: Monday, 22February2016, 2pm. Please submit the soft copy to , or hard copy to theInternational Relations Office at Shaw Foundation Alumni House, Level 3
  • Please attach this completed form, together with CVUnofficial Transcript (from Student Integrated System) for submission
  • Selected students may be contacted to attend an interview between 24 and 26 February 2016

SECTION A - PERSONAL PARTICULARS
Name / Matriculation No.
NUS Email / Personal Email
Home Number / Mobile Number
Nationality / Race
Date of Birth
(dd/mm/yyyy) / Age
NRIC / Gender
Passport Number / Passport Expiry Date
(dd/mm/yyyy)
Home Address
Scholarship / Awards
Hobbies / Special Interest or Talent
SECTION B – ACADEMIC RECORD
Home Faculty
Major(s) / Minor(s)
Year of Study / Current CAP
SECTION C – MEDICIAL PARTICULARS
Please state where applicable.
  • Medical Condition / Allergy:

  • Dietary Constraint:

  • Disability:

SECTION D – LANGUAGE PROFICIENCY
‘O’ Level Chinese Result / ‘A’ Level Chinese Result
Chinese Language Proficiency / [ ] Good [ ] Average [ ] Poor [ ] None
SECTION E – CONTACT PERSON (Parents / Guardian in Singapore)
Name / Relationship with Participant
Home Number / Mobile Number
Address

*Please delete where appropriate.

  1. I have / have not* participated in any Student Exchange Programme (SEP) or other overseas summer programmes/special programmes previously.
    If yes, where? Please indicate the programme name. ______
  2. I have submitted my result slips of all semesters taken to-date at NUS together with this application form.
    YES / NO*
  1. I have attached my resume / CV.
    YES / NO*

I certify that the information given above is accurate.

Signed: / Date:
SECTION F – Essay Section
In approximately 500 words, please tell us:
1)How you will be able to contribute to the Sino-Singapore Undergraduate Exchange Programme?
2)What you hope to gain from this opportunity and experience.

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