2014 DR GOH KENG SWEE (GKS) SCHOLARSHIP INSTRUCTIONS TO APPLICANTS

1. There are 3 parts in this application you must complete Form, Essay and Declaration & Survey . All parts must be completed in English. Please be reminded that you must select the "Yes, I agree" option, to agree to the clause under Declaration. 2. Please note the following, in completing your application form: Yellow fields are compulsory and must be completed. Indicate 'Nil' if fields are not applicable. Blue fields should be entered if the relevant information is available. Please refer to the tab Sample Form within the file for your reference. Fields marked with a red triangle in the top right corner contains help text. Hover your mouse cursor over the field to read this text. Do not add, delete or format any cells in the application form. 3. Email completed applications (Form, Essay and Declaration & Survey) to applications@psd.gov.sg, by 19 February 2014. Incomplete applications and applications received after this date will not be considered. 4. Photocopies of your birth certificate/passport and educational certificates must be produced for verification purposes upon request.

Personal and Family Particulars

Academic Results

Prizes / Awards / Co-Curricular Activities

Notable Achievements Year

Other Information
Application for University Admission Singapore Universities 1st choice Select an option Option Select an option 2nd choice Select an option Option Select an option 3rd choice Select an option

Subject

Grade

Family Background Father

Mother Select an option 4th choice Select an option

Option

Option Siblings Select an option Select an option Overseas Universities Option Select an option Are the above results your final results? If "No", please indicate expected date of receiving your final results: Select an option MMYYYY Option SAT Scores (1) Scholastic Assessment Test I Critical Reading Math Writing Note: If your SAT I scores are not available yet, or if you are expecting a new set of results, you may update us via email by 1 March 2014. (2) Scholastic Assessment Test II National Score Percentile Select an option Select an option Select an option 5th choice Select an option Option

Select an option

Option Select an option Application for Other Scholarship(s) Select an option Select an option

Select an option

Currently studying in SG under a scholarship? Select an option

Select an option Select an option

Additional information Select an option Select an option Select an option

Essay
In the yellow field below in no more than 500 words, describe an experience or incident that has shaped your values. How did this experience or incident affect you? How did you change as a result of this experience or incident? Sample Text

Do you hold any citizenship, other than the one entered in the "Form" section?

Select an option Select an option Select an option Select an option Select an option Select an option

Do you hold Permanent Residence Status of any other country?

Have you ever suffered, or are you suffering from any physical impairment, disease or mental illness?

Have you ever been convicted in a court of law in any country?

Have you previously applied for the Dr. Goh Keng Swee Scholarships?

Have you studied in Singapore before?

By submitting this form to PSC, I declare that the information provided in this application is correct. I declare that the information in all parts of this form are true to the best of my knowledge, and I have not wilfully suppressed any material facts. I understand that any provision of inaccurate or false information or omission of information will render my application invalid and that, if admitted on the basis of such information, I will be required to withdraw from the scholarship. Select an option

Survey
Thank you for you interest in the Dr Goh Keng Swee scholarship. To help us in our review and publicity efforts, please let us know where you have obtained information on the Dr Goh Keng Swee Scholarships

Please let us know if you have any other feedback or comments on the application exercise below.

Form
Personal and Family Particulars
Alyssa Kristiano 9/14/1993 Indonesia Citizen 123456789X Family Background Father Arthur Kristiano Indonesia Citizen Author N.A. Mother Athena Wijaja Indonesia Citizen Homemaker N.A. Siblings Alexander Kristiano Brother Indonesia Citizen Student Excelpro High School Amelia Kristiano Sister Indonesia Citizen Student Excelpro High School Angelina Kristiano Sister Indonesia Citizen Student Glory Junior School Angelina Kristiano Sister Indonesia Citizen Student

All Yellow Fields are compulsory Academic Results

Excelpro High School 2007-2012 Surat Tamat Sekolah Menengah Umum Tingkat Atas 2012 Grade Subject A English A Indonesian Language B Mathematics A Physics A Chemistry B History B Sociology C Arts

Blue Fields are to be filled if info is available Other Information

Year 2010 2011-2012 2011 Dec 2011 Application for University Admission Singapore Universities 1st choice National University of Singapore Business Administration Pending University's Reply 2nd choice Nanyang Technological University Business Pending University's Reply 3rd choice Singapore Management University Engineering and Management Science Pending University's Reply 4th choice

Prizes / Awards / Co-Curricular Activities

Notable Achievements National Mathematics Challenge 2009 Runner-up Excelpro High School Nature Appreciation Club President Co-organised Project Samaritan (an event to distribute collected donations to the homeless) Volunteer of the Month - nominated for community service contributions at Milendra Family Service Centre

Double Degree

5th choice

Overseas Universities

Are the above results your final results? If "No", please indicate expected date of receiving your final results:

No 03/2013

National SAT Scores Score Percentile (1) Scholastic Assessment Test I Critical Reading 86 740 Math 79 690 Writing 89 760 Note: If your SAT I scores are not available yet, or you are expecting a new set of results, you may update us via email by 1 March 2014. (2) Scholastic Assessment Test II

Application for Other Scholarship National University of Singapore Local Scholarship Business Administration Pending Organisation's Reply

Do you hold any citizenship, other than the one entered in the "Form" section? Do you hold Permanent Residence Status of any other country? Have you ever suffered, or are you suffering from any physical impairment, disease or mental illness? Have you ever been convicted in a court of law in any country? Have you previously applied for the Dr. Goh Keng Swee Scholarships? Have you studied in Singapore before? 2002 - 2003, Anglo Chinese School (Junior),

No No No No No Yes

By submitting this form to PSC, I declare that the information provided in this application is correct. I declare that the information in all parts of this form are true to the best of my knowledge, and I have not wilfully suppressed any material facts. I understand that any provision of inaccurate or false information or omission of information will render my application invalid and that, if admitted on the basis of such information, I will be required to withdraw from the scholarship. Yes, I agree.

Survey
Thank you for you interest in the Dr Goh Keng Swee scholarship. To help us in our review and publicity efforts, please let us know where you have obtained information on the Dr Goh Keng Swee Scholarships

I heard about the scholarships from my school senior and googled for the Dr. Goh Keng Swee scholarship website.

Please let us know if you have any other feedback or comments on the application exercise below.

None. Thank you.