Page 2 of 4 PARENT S INFORMATION 家长资料 Father s Name 父亲姓名 Mother s Name 母亲姓名 Passport. 护照号码 Passport. 护照号码 Company Name 公司名称 Position 职位 Company Name 公

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1 Page 1 of 4 STUDENT S PARTICULARSRS 学生资料 Name (as shown on passport) 姓名 Date of Birth (dd/mm/yyyy) 生日 ( 日 / 月 / 年 ) Age 年龄 Gender 姓别 Male 男 Female 女 Passport 护照号码 Date of Expiry 护照到期日 Type of Pass Held 持有通行证 Singaporean / Singapore P.R (I.C.) Address in Singapore 新加坡地址 Dependant Pass (FIN) Student Pass (FIN) Race 种族电邮地址 Religion 宗教信仰 Contact 联络电话 STUDENT S EDUCATIONAL DETAILS 学生的教育背景 Name of School 学校名称 Province, City or State Country Year Started Year Ended Highest Level Completed 城市或地区国家开始就读年份结束就读年份完成之最高学历 Name of School 学校名称 Province, City or State Country Year Started Year Ended Highest Level Completed 城市或地区国家开始就读年份结束就读年份完成之最高学历 Has your child taken any English lessons outside the school? 您的孩子是在校外参与英语补习? If yes, please state 若有参加, 请选择是哪一种补习 Private Tutor Language School How Long months / years

2 Page 2 of 4 PARENT S INFORMATION 家长资料 Father s Name 父亲姓名 Mother s Name 母亲姓名 Passport. 护照号码 Passport. 护照号码 Company Name 公司名称 Position 职位 Company Name 公司名称 Position 职位 Company s Address 公司地址 Company s Address 公司地址 Personal 电邮地址 Personal 电邮地址 Home Address 住家地址 Home Address 住家地址 Contact 联络电话 Contact 联络电话 (Office) 公司 (Office) 公司 GUARDIAN DETAILS 监护人资料 Name of Guardian 监护人姓名 I.C. 身份证号码 Gender 姓别 Male 男女 Female Relationship 与学生关系 Address 电邮地址 Singapore Address 新加坡住址 Contact. 联络电话 PERSON TO CONTACT FOR EMERGENCY CASES 紧急事件联络人 Father 父亲 Mother 母亲 Guardian 监护人

3 Page 3 of 4 CHILD S LEARNING NEEDS 学生学习状况 Has your child/ward ever had (Please submit all pertaining documents) 请问您的孩子是有病例情况 ( 请提交相关文件 ) Enrichment or remedial help( 强化或治疗的协助 ) A learning difficulty( 学习障碍 ) A behavior difficulty( 行习障碍 ) Psychological assessment / treatment( 心理治疗 ) (If Yes, please attached appropriate report) ( 若有以上的状况, 请附上有关报告 ) HEALTH 学生健康状况 Does your child/ward have any health problem, which may have an Influence on his/her participation in the classroom or at sports? For example, does your child have any allergies? Please submit all medical reports pertaining to any health problem(s). 您的孩子 / 收监护人是有任何健康方面的问题? 是方面的问题是会影响学生的学习或是参与学校活动?( 例如 : 您的孩子是有过敏症状?) 请将相关方面的资料详细写出并附上医学证明 Documents to Submit 1. Copy of the Student s Passport and Original Birth Certificate (Official and notarized translation of documents is required if they are not in English language) 2. Copy of the Student s Dependent Pass/PR Identity card/student pass (if applicable) 3. Copy of the last 1 3 years school report book/transcripts (Official and notarized translation of documents is required if they are not in English language) 4. Copy of Vaccination/Immunization Record 5. (Only for kindergarten and primary years applicant) 6. 2 passport-sized photographs 7. Copy Form V103 and eform 16 (For Student Pass application) 8. Copy of Parents Passports (Both Father s and Mother s) 9. Copy of Parents Employment Pass/Dependent Pass/PR Identity card (Both Father s and Mother s) 请提交下列文件 1. 学生护照复印件 2. 学生出生证明复印件 ( 若非英文, 需翻译及公证 ) 3. 学生依亲通行证 / 新加坡永久民居留证 / 学生准证复印件 ( 若有 ) 4. 学生过去一到三年的学校成绩单复印件 ( 若非英文, 需翻译及公证 ) 5. 学生疫苗接种记录 ( 仅限于学生签证申请者 ) 6. 2 张护照型照片 7. 表格 V103 及表格 e16 ( 仅限于学生签证申请者 ) 8. 父母亲护照复印件或身份证复印件 9. 父母亲工作证复印件 / 依亲通行复印件 / 新加坡永久居民居留证复印件

4 Page 4 of 4 SIGNATURES 家长签名 I declare that the information on this application form for my child to study at HWA is true and correct. I confirm that no false statement or misrepresentation has taken place I give permission to the school authorized personnel to photograph students for school publications, including but not limited to the school newsletter, poster, website, etc. (Parents and Guardian are to initiate opt out by using the Opt-out form, if they do not wish their child/ward to be photographed). I understand that my child will be required to take the Placement Test including an oral/interview with the school in order to officially confirm the entry level based on the results of the test. I hereby agree to accept decision made by the school on my child s placement to be final. I also understand that the paid enrolment fee and registration fees will not be refunded if my child is unsuccessful in gaining entry. I will not hold the school responsible should my child s application to study at HWA be rejected by either the Ministry of Education, Singapore or the Immigration & Checkpoints Authority. HWA reserves the right to vary or reverse any decision regarding my child s admission or enrolment made on the basis of incorrect and incomplete information. 我在此声明递交给学校的资料都是正确属实的学校将会因活动或广告的需要, 会拍摄学生在学校里的上课状况, 例如刊登在校内时事通讯, 海报, 网站上等如果家长不希望自己孩子的照片出现在任何媒体上, 家长或监护人必须主动要求, 填写相关表格我清楚了解学生在入学之前必须参加学校的入学考试, 学生入学的年级是依照入学考试的成绩来判定的我也了解所交付的报名费和注册是不能退还的我了解学生的申请若被新加坡移民厅或是教育部拒绝, 学校将不承担责任当学校发现学生所附的资料不属实, 学校有权利拒绝学生入学我谨此授予 HWA 权力在紧急的时侯将我的孩子送至最临近的治疗中心医院我也了解将竭尽所能在第一时间通知我然而 xxx 无法联系上家属或有关人员, 我将授予校方的医护人员权力进行医疗任何因向校方提供不完整医疗记录而引起的事故, 学校将不会承担任何责任有个人信息严格保密 : 除政府部门要求外, 信息仅供学校内部使用 I hereby authorize the School permission to drive my child/ward to the nearest medical centre/hospital for emergency treatment and I understand that the School personnel will do his/her best to inform us as soon as possible, however if none of the emergency contact names can be reached at the time of the emergency, I authorize the school medical personnel to proceed with all emergency treatment. I will not held any HWA personnel liable for any accident resulting from any withheld medical information. All students data is strictly confidential and for internal use only, unless it is requested by government agencies. Signature of applicant 申请人签名 Signature of Parent / Guardian 家长 / 监护人签名

5 FOR STAFF USE ONLY FOR OFFICIAL USE ONLY DOCUMENTS CHECKLIST 入学清单 Pre-Course Counselling Form 前期咨询表格 Initial Assessment of Entry Requirements 入学条件初步评估 Placement Test (If applicable); otherwise, indicate N.A 入学测试 ( 若有 ); 若不适用, 请注明 N..A Student Selection Interview Form 遴选面试表 Verification of Originality and Authenticity of Documents 原文件公证证明 Student Management System Update (New Applicant) 更新学生管理系统信息 ( 新申请 ) Copy of the Student s Passport and Original Birth Certificate (Official and notarized translation of documents is required if they are not in English language) Copy of the Student s Dependent Pass/PR Identity card/student pass (if applicable) 学生护照复印件学生出生证明复印件 ( 若非英文, 需翻译及公证 ) 学生依亲通行证 / 新加坡永久民居留证 / 学生准证复印件 ( 若有 ) Copy of the last 1 3 years school report book/transcripts (Official and notarized translation of documents is required if they are not in English language) 学生过去一到三年的学校成绩单复印件 ( 若非英文, 需翻译及公证 ) Copy of Vaccination/Immunization Record (Only for kindergarten and primary years applicant) 学生疫苗接种记录 ( 仅限于学生签证申请者 ) 2 passport-sized photographs 2 张护照型照片 Copy Form V103 and eform 16 (For Student Pass application) 表格 V103 及表格 e16 ( 仅限于学生签证申请者 ) Copy of Parents Passports (Both Father s and Mother s) 父母亲护照复印件或身份证复印件 Copy of Parents Employment Pass/Dependent Pass/PR Identity card (Both Father s and Mother s) 父母亲工作证复印件 / 依亲通行复印件 / 新加坡永久居民居留证复印件 Carried out and collected by 执行收集人 Name & Signature of Admission Executive 招生负责人姓名和签名 Verified by 核实人 Name & Signature of HOD 部门负责人姓名和签名

Microsoft Word - (web)_F.1_Notes_&_Application_Form(Chi)(non-SPCCPS)_16-17.doc

Microsoft Word - (web)_F.1_Notes_&_Application_Form(Chi)(non-SPCCPS)_16-17.doc 聖保羅男女中學學年中一入學申請申請須知申請程序 : 請將下列文件交回本校 ( 麥當勞道 33 號 ( 請以 A4 紙張雙面影印, 並用魚尾夾夾起 : 填妥申請表並貼上近照小學五年級上下學期成績表影印本課外活動表現及服務的證明文件及