BRIDGING@NTU

Application for a Replacement Bridging Card

POINTS TO NOTE:
1) / You are to complete this application form in block letters.
2) / Payment of $21.40 (inclusive of GST) by NETS, NETS CashCard, ez-link Card and Credit Card can be made during payment hours [Monday – Thursday, 8.30am – 5.00pm and Friday, 8.30am – 4.45pm] at:
One Stop @ SAC: 50 Nanyang Avenue, NS3-01-03, Academic Complex North, Singapore 639798
URL: http://www.ntu.edu.sg/has/Graduate/Pages/OneStopSAC.aspx
Online Map: http://maps.ntu.edu.sg/maps#q:NS3-01-03
3) / You are to keep the official receipt. You are required to produce the receipt and this application form upon submission of your request for a replacement card. The completed application form and the official receipt are to be submitted to OAFA (Level 3, Student Services Centre) (wef 1 August 2015).
4) / You will not be required to submit a new photograph if you have been issued with a bridging card before.
5) / Your replacement card will only be ready for collection 7 working days after the submission of this application form and your payment receipt. Your replacement card can be collected during the following hours [Monday – Thursday, 8.30am – 5.00pm and Friday, 8.30am – 4.45pm] at:
OFFICE OF ADMISSIONS & FINANCIAL AID
Level 3, Student Services Centre (wef 1 August 2015)
42 Nanyang Avenue
Singapore 639815
6) / You are to collect your replacement card in person. You may not ask a friend to collect your card on your behalf. Replacement cards will not be sent out via post.
7) / No refund will be given in the event that you retrieve your original card once you have made payment and submitted the application form and payment receipt. You are to return the original card, if found, once a new card has been issued.
A.  PERSONAL PARTICULARS
Name (as in passport): / Name (in Chinese characters): / Gender:
M F
Passport No: / FIN:
Bridging Number: / Mobile No. (Singapore):
Email: / Bridging Batch:
19B / 20B / 21B / 22B
B.  DECLARATION
I declare that all information given in this form is true and accurate to the best of my knowledge and I have not wilfully suppressed any material fact. I understand that:
1)  I will render myself liable to appropriate action if the information provided turns out to be false or inaccurate.
2)  OAFA reserves the right to refuse to accept this application.
Name & Signature of Scholar: / Date:
C.  FOR OAFA USE
Payment Made:
¨ Yes ¨ No / Receipt Received:
¨ Yes ¨ No / Date of Collection: / Processed by: / Date:

TALENT OUTREACH SECTION

Office of Admissions & Financial Aid

Student Services Centre Level 3, 42 Nanyang Avenue, Singapore 639815

Tel: +65 67906633 | Fax: +65 6794 6510 | Email: