Vous êtes sur la page 1sur 5

Maybank Scholarship Award

Instructions to Applicants
1. Please use a BLACK or BLUE ballpoint pen to fill in this application form.
2. The application form is to be completed in English.
3. Applicants must attach the following documents as part of their application:
Recent Passport-size photo
Identification Card (front & back) for:
o
Applicant
o
Both parents and/or guardian(s)
o
Both guarantors

Examination results (PMR, SPM, etc.)


Testimonial and recommendation letter from school
Leaving school certificate
Co-curricular certificate(s), etc.
Latest Income Tax Return, EA Form, Payslip/Proof of Income AND EPF statement for:
o
Both parents and/or guardian(s)
o
Both guarantors
o
Siblings
4. Incomplete applications and applications that do not comply with our requirements will NOT be
considered.

How to Apply
1. Send this application form with all certified true copies of documents required to:
MAYBANK SCHOLARSHIP AWARD 2012 - OVERSEAS
RESOURCING CENTRE
GROUP HUMAN CAPITAL
44TH FLOOR, MENARA MAYBANK
100, JALAN TUN PERAK
50050 KUALA LUMPUR
2. Closing date: 22nd APRIL 2012.
Incomplete applications received after closing date will not be considered.
3. Successful applicants will be notified via e-mail. Only shortlisted candidates will be notified.

Preferred Degree Details


Preferred Course 1

Bachelor of

Preferred Course 2

Bachelor of

Preferred Course 3

Bachelor of

Personal Details
Full Name (as per NRIC):
Identification No.:

Date of Birth:

Sex:

Male / Female

DD / MM / YYYY

Ethnicity:

Citizenship:

Religion:

House Tel No.:

Mobile Tel No.:

E-Mail Address:
Permanent Address:

Postcode:

State:

Postcode:

State:

Correspondence Address:
(if different from above)

Qualifications
Level

Name of School

State

Qualification

Grade Obtained
A

Secondary School

Others

Others

Co-Curricular Activities
Most recent activities in which you assumed leadership position(s)
Year

Position Held

Society / Club / Activity

Institution

Level Represented

Institution

Most recent sports activities represented


Year

Sport Activity

Most recent academic awards & commendations received


Year

Awards/Commendations Received

Family Particulars
Please fill in the details of all your immediate family members and/or guardian(s)

Year

(Completed)

Full Name

Relationship

Age

Occupation

Monthly Gross
Income

Status

Monetary Aid from Other Organisations


Please state all monetary aid previously received & currently receiving
Organisation

Amount

Form of Assistance
(Scholarship/Loan)

Period of Aid
(yyyy yyyy)

Guarantors Details
All nominated guarantors must have good credit and earn a monthly income
Guarantor 1

Full Name (as per NRIC):


Identification No.:

Date of Birth:

Relationship:

Citizenship:

Occupation:

Monthly Gross Income:

House Tel No.:

Mobile Tel No.:

DD / MM / YYYY

E-Mail Address:
Permanent Address:

Postcode:

State:

Guarantor 2

Full Name (as per NRIC):


Identification No.:

Date of Birth:

Relationship:

Citizenship:

Occupation:

Monthly Gross Income:

House Tel No.:

Mobile Tel No.:

DD / MM / YYYY

E-Mail Address:
Permanent Address:

Postcode:

State:

Essay Writing
Please write in the space below why you should be selected as a recipient of the Maybank Scholarship Award.

_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________

Declaration
Have you ever been convicted by a Court of Law of any country?

Yes / No

If yes, please give brief details:


____________________________________________________________________________________________________
____________________________________________________________________________________________________
Are you or any of your family members suffering / have suffered from any medical conditions (mental and physical)
which requires regular or prolonged medical treatment?
Yes / No
If yes, please give full details:
____________________________________________________________________________________________________
____________________________________________________________________________________________________
Please list if you have relatives working in Maybank Group:
Name of Relative

Relationship

Personnel No.

Branch / Department

I hereby declare that the information provided in this application form is true and correct and I authorise and consent
to Maybank obtaining official records, if necessary, from any educational institution attended by me. I understand that
any provision of inaccurate or false information or omission of information will render this application invalid and that,
if admitted on the basis of such information, I can be required to withdraw from the scholarship.

____________________________
Signature of Applicant
Date: _______________________

Checklist of Document Submitted


Recent Passport-size photo
Identification Card (front & back) for:
Applicant
Both parents and/or guardian(s)
Both guarantors
Examination results
Testimonial and recommendation letter from school
Leaving school certificate
Co-curricular certificate(s), etc.
Latest Income Tax Return, EA Form, Payslip/Proof of Income AND EPF Statement for:
Both parents and/or guardian(s)
Both guarantors
Siblings