Application Form
Submitted by: (Agency Name)
PROGRAMME APPLIED First Choice
*Please cancel where applicable
Diploma/Degree/Masters* in
Specialisation/Domain/Principal Study:
□ Admission Test/Audition
□ Portfolio/Personal Statement Submission Second Choice
*Please cancel where applicable
Diploma/Degree* in
Specialisation/Domain/Principal Study:
□ Admission Test/Audition
□ Portfolio/Personal Statement Submission APPLICANT’S DETAILS
Full Name:
(in Chinese Characters, if available)
[ ]
Identification Number:
(Passport Number/Identification Card Number/FIN)
Date of Birth
(DD/MM/YYYY): Gender: □ Male
□ Female
Race: Religion:
Citizenship/
Nationality:
Country/
Province/
State of Birth:
Marital Status: □ Single □ Married □ Divorced
Permanent Address (Home):
Contact Numbers: (Home) (Mobile)
Email Address:
Application No:
APPLICANT’S ACADEMIC REPORT – GENERAL AND HIGHER EDUCATION
School Attended Qualification Obtained Year
Obtained
APPLICANT’S ENGLISH PROFICIENCY
English Language Exam Taken English Language Score Year
Obtained
ART RELATED ACHIEVEMENTS (IF ANY)
HOW DID YOU LEARN ABOUT US?
(Please tick all that apply)
□ NAFA Website
□ Email from NAFA
□ Web banners or videos
□ Search Engines
□ Teachers, friends or relatives
□ Open House
□ Overseas recruitment agent
EMERGENCY CONTACT/PARENT/GUARDIAN/ DETAILS EMERGENCY CONTACT
Name:
Relationship with emergency contact person:
Contact Numbers: (H) (O) (HP)
FATHER (DIPLOMA/DEGREE APPLICANTS ONLY)
Unable to provide contact information: □ Deceased □ Not in contact Name:
Occupation:
Nationality:
Contact Numbers: (H) (O) (HP)
Email Address:
Identification Number:
Singapore Permanent Resident: □ Yes □ No Stayed or worked in Singapore: □ Yes □ No MOTHER (DIPLOMA/DEGREE APPLICANTS ONLY)
Unable to provide contact information: □ Deceased □ Not in contact Name:
Occupation:
Nationality:
Contact Numbers: (H) (O) (HP)
Email Address:
Identification Number:
Singapore Permanent Resident: □ Yes □ No Stayed or worked in Singapore: □ Yes □ No
GUARDIAN (DIPLOMA/DEGREE APPLICANTS ONLY) (if applicable)
Name:
Relationship to Applicant:
Email Address:
Address:
Contact Numbers: (H) (O) (HP)
TUITION GRANT APPLICATION & DECLARATION (DIPLOMA PROGRAMMES ONLY)
Eligible Singapore Permanent Residents (SPRs) and International Students may choose to apply for a Tier B and a Tier C Tuition Grant respectively. There is a limited number of Tuition Grants available for International Students, and these are awarded on a competitive basis based on merit.
If you take up the Tuition Grant, you will be required to secure employment and serve in a Singapore entity for three years upon graduation. If you wish to apply, please fill in the following as part of your application.
I understand that if I am offered and accept a Tuition Grant for my studies:
• I am required to sign a Tuition Grant Agreement with the Government of Singapore after matriculation, and secure employment and serve in a Singapore entity for 3 years upon graduation
• I am required to have two sureties to sign the Tuition Grant Agreement. My sureties must be above 21 and 65 years of age, and must not be undischarged bankrupts
In applying for a Tuition Grant, I confirm that I agree to the terms and conditions set forth below.
I am aware that knowingly providing false information in this form is a criminal offence under Section 177 of the Penal Code, is punishable with imprisonment for a term up to 6 months, or a fine up to a maximum of
$5,000 or with both.
Note: You are eligible for a Tuition Grant if you have not previously completed a programme at an equal or higher level than the programme you are applying for, for which you have previously received a subsidy or sponsorship from the Government of Singapore.
Please select one of the following:
□
No, I do not wish to apply for Tuition Grant. I will pay full fees throughout my duration of study.□
Yes, I wish to apply for a Tuition Grant. I am prepared to sign a Tuition Grant Agreement with the Government of Singapore, which would require that I secure employment and serve in a Singapore entity for three years upon graduation.• I declare that the information provided by me in this declaration form is true and accurate, and I have not deliberately or wilfully omitted to provide any information that would render me ineligible to receive Tuition Grant.
• Should I make a false declaration, I understand that:
i. I will be committing a criminal offence that may be punishable with a jail term and/or fine.
ii. I will not be eligible to receive the Tuition Grant and be liable for liquidated damages (i.e. total sum of the Tuition Grant provided with 10% compounded interest per annum). I will still be liable for such a penalty even if I have graduated from my programme at the point when the false declaration is discovered.
If you wish to apply for a Tuition Grant, please declare one of the following:
□
I have not received any Tuition Grant or other sponsorship/subsidy from the Singapore government previously for a programme at the same or a higher level as my new programme.a) I wish to receive a Tuition Grant and pay subsidised tuition for my new programme b) I agree to pay non-subsidised fees if I subsequently become ineligible for the Tuition
Grant during the period of my new programme
□
I have received a Tuition Grant or other sponsorship/subsidy from the Singapore Government for a previous programme at the same or a higher level as my new programme, but I did not graduate/have not graduated from the programme.a) I am aware that the Tuition Grant or other Government sponsorship/subsidy that I have previously received will be taken into consideration in assessing my Tuition Grant eligibility for my new programme
b) I agree to pay non-subsidised fees for my new programme if I am assessed to be ineligible for the Tuition Grant
□
I have received a Tuition Grant or other sponsorship/subsidy from the Singapore Government for a previous programme at the same or a higher level as my new programme, and I have graduated from the programme.a) I am aware that I am ineligible for Tuition Grant at my new programme b) I agree to pay non-subsidised fees for my new programme
MODULE EXEMPTION APPLICATION (DIPLOMA PROGRAMMES ONLY)
• Exemption of a NAFA Diploma module may be granted to new students who have, prior to being admitted to NAFA, taken and passed identical or equivalent module(s) in another institution.
• The granting of module exemption(s) may be subject to passing a Portfolio Interview, Audition or Admission Test.
• No more than 60 modular credits can be exempted for any student.
• Applicants must submit their applications for module exemption together with their applications for admission.
□ Yes, I would like to apply for Module Exemptions
□ No, I do not wish to apply for Module Exemptions
DECLARATION STUDENT’S PASS
Have you studied in Singapore before?
If yes, please specify and submit a copy of your Student’s Pass, if possible
□ Yes
□ No FIN:
Institution:
Period of Study:
Have you ever been rejected by ICA for your application for the Student’s Pass?
If yes, please specify.
□ Yes
□ No Month/Year:
Have you ever held a Work Permit/ Work Pass/ Employment Pass/ S-Pass/
EntrePass/ Personalised Employment Pass/
Training Employment Pass/ Work Holiday Pass/ Dependent’s Pass?
If yes, please specify.
□ Yes
□ No FIN:
Details of Pass Held:
Expiry Date:
Have any of your parents held or are holding a work permit or other pass in Singapore?
If yes, please specify.
□ Yes
□ No FIN:
Details of Pass Held:
Expiry Date:
SPECIAL EDUCATION NEEDS
NAFA acknowledges the potential of our students and the diversity of learning capabilities. The Academy will, within our given resources, facilitate and support students with Special Education Needs (SEN). Students who inform and declare their learning needs (supplemented with the relevant medical reports) prior to admission or after, will meet with the Office of Student Care and the school before beginning their studies to discuss the types of support required to maximise their learning experience.
Do you have any past or current physical and/or mental health conditions, learning needs, disabilities, illness or impairments which may cause you to require special assistance in terms of facilities or academic support while studying at NAFA?
Physical Impairment O Wheelchair Users O Cerebral Palsy O Muscular Dystrophy O Dyspraxia
□ Yes
□ Yes
□ Yes
□ Yes
□ No
□ No
□ No
□ No
Hearing Impairment
O Total or Partial Hearing Loss
O Central Auditory Processing Disorder □ Yes
□ Yes □ No
□ No
Visual Impairment
O Total or Partial Visual Loss
O Visual Processing Disorder □ Yes
□ Yes □ No
□ No
Social and Behavioural Difficulties O ADHD
O Autism Spectrum Disorder □ Yes
□ Yes □ No
□ No
Learning and Language Difficulties O Development Language Disorder O Down’s Syndrome
O Dyscalculia O Dyslexia
O Global Developmental Delay
□ Yes
□ Yes
□ Yes
□ Yes
□ Yes
□ No
□ No
□ No
□ No
□ No
Other mental health conditions
Please specify: ______________________________________ □ Yes □ No
• I affirm that all the information provided during my application and enrolment are true and accurate to the best of my knowledge. I have not deliberately omitted any relevant fact.
Should I be admitted into NAFA on the basis of inaccurate or false information, I understand that I will render myself liable to appropriate action, including civil action, expulsion from programme, forfeiture of fees, fine and other disciplinary action.
• I will submit the latest medical report(s) pertaining to the above conditions, whenever applicable.
• I also give my consent, should I be admitted into NAFA, to permit the discreet sharing of my medical condition and/or special needs by the Academy with relevant parties.
Signed by Student: Signed by Parent/Guardian*:
(*for students below 18 years of age)
Name: Name:
Identification No: Identification No:
Date: Date:
Note: Please use the same signature as you had in Form 1A: Pre-Course Counselling Checklist (Diploma), Form 1B: Pre-Course Counselling Checklist (Bachelor’s) or Form 1C: Pre-Course Counselling (Master’s)
Verification by Agent
I have verified the originality of the supporting documents submitted relating to this application.
Signed by Agent
Name:
Date:
Vetted by Student Admissions Office Signed by SAO
Name:
Date:
