12
Ր㺛Җ䇗δቅᆜε CDAC Tuition Programme (Primary) 2017 ⭩䈭 How to Apply 䈭ሼ⭩䈭㺞Ṳᡶ䴶ᖧদᮽԬ䛤ᇺᡌӚ㠩Ր『Ҝ༺ᡌԱ Րѣᗹ &'$& %XLOGLQJ 7DQMRQJ .DWRQJ 5RDG 6LQJDSRUH Ր『Ҝ༺ޢ䰪φ ᱕ᵕж㠩᱕ᵕφрॾ ۃ᱕ᵕӊφрॾ ۃ᱕ᵕޣφрॾ 㠩сॾ Րᆜ⭕ᮏ㛨фਇኋ㓺✣㓵ਭ⸷φ Please mail the application form and required photocopied documents to CDAC Secretariat or any CDAC Centre CDAC Building, 65 Tanjong Katong Road, Singapore 436957 CDAC Secretariat Office Hours: Monday to Thursday: 8.30 am to 6.00 pm Friday: 8.30 am to 5.00pm Saturday: 8.30 am to 1.00 pm CDAC Student Education & Development Dept Hotline: 6603 5555 Րѣᗹᔶ᭴䰪 ᱕ᵕж㠩᱕ᵕӊφсॾ 㠩Აр ᱕ᵕޣ᱕ᵕᰛφрॾ 㠩ۃ2016 11 11 ᰛȽ12 24 31 ޢٽᵕՇᚥ ߏуᇂ᮪ᡌ⋗ᴿ䱺рᡶ䴶ᮽԬⲺ⭩䈭㺞Ṳሼу⨼ Operating Hours of CDAC Centres Monday to Friday: 1.00 pm to 10.00 pm Saturday & Sunday: 10.00 am to 5.00 pm Closed on 11 November 2016, 24 and 31 December 2016 and Public Holidays Incomplete application form or application form without required documents will NOT be processed Րѣᗹ CDAC Centre ൦൶ Address Րѣᗹ CDAC Centre ൦൶ Address ᇅ㤸ẛ Ang Mo Kio Blk 201 Ang Mo Kio Avenue 3 #01-1648 S560201 ␗┞ቲ Tampines Blk 158 Tampines Street 12 #01-77 S521158 (ѣᗹሼᲸ䰣 Centre is temporarily closed: 20/10/16 – 2/1/17) व⍑ Bedok Blk 138 Bedok North Street 2 #01-185 S460138 ↜ਿ⨣䇟 Bukit Panjang Blk 270 Bangkit Road #01-22 S670270 ѯᡄђ Tanjong Katong 65 Tanjong Katong Road, Blk B Level 1 S436957 㼋ᔀ Jurong Blk 421 Jurong West Street 42 #01-1045 S640421 ཝᐪデ Toa Payoh No. 381 Lorong 1 Toa Payoh Level 2, OnePeople.sg Building S319758 ῒ呻 Punggol Blk 512 Hougang Avenue 10 #01-67 S530512 ݶ Woodlands Blk 680 Woodlands Avenue 6 #01-764 S730680 㓘ኧ Redhill Blk 83 Redhill Lane #01-85 S150083 ⋯⊖ Yew Tee Blk 627 Choa Chu Kang Street 62 #01-160 S680627 ⴑ⑥ Sengkang Blk 321B Anchorvale Drive #01-196 S542321 ѿ亰 Yishun Blk 145 Yishun Street 11 #01-41 S760145 䭏䗽⭩䈭ᰛᵕφㅜਾᶗԬⲺᆜ⭕䘎ᱥਥԛ൞Ա⇫⭩䈭ޛ㺛Җ䇗θռᗻ亱ⵁᱥੜᴿ֏Ⲻᆜ仓Ⱦ䈜䈭৸䰻с㺞Ⱦ Missed the Application Date: Students who meet the eligibility criteria may apply to join the Tuition Programme at any point of time but is subjected to places availability. The table below on monthly intake cut-off date is for your reference. ⭩䈭㺞ṲӚᰛᵕ Application form received within: ᔶ䈴ᴾԳ Commencement Month 17/12/2016 – 6/1/2017 ӂᴾ February 7/1/2017 – 6/2/2017 пᴾ March 7/2/2017 – 6/3/2017 April 7/3/2017 – 5/6/2017 йᴾ July 6/6/2017 – 7/7/2017 ޡAugust 8/7/2017 – 7/8/2017 ғᴾ September 䈭⌞ᝅφ ᡆ⭩䈭㘻ሼ൞ ᒪ ᴾ㧭ᗍҜ䶘䙐⸛ҜȾਠᴿ൞ᴿ䏩ཕ ᆜ⭕ᔶ⨣ⲺсθᛞᢃՐ㧭ᗍ㺛Җ⨣Ⲻᆜ仓Ⱦ ᒪ ᴾ ᰛᡌҁᡶⲺਾṲ⭩䈭θᆜ仓䞃ሼṯᦤ㺛 Җ⨣ᱥੜᴿグ㕰㙂ᇐȾ 㺛Җ䇗൞ ᴾ ᴾڒ䈴θ⋗ᴿᤑᆜ⭕Ⱦ 㺛Җ⨣ሼ൞ ᴾᰢ ᴾᰢδ㿼ᒪ㓝㙂ᇐε㔉ᶕθഖ↚ ᴾ ᰛ ҁу߃Ⲻ⭩䈭㺞ṲȾቅᆜޣᒪ㓝Ⲻ㺛Җሼ൞ ᴾѣᰢ㔉 ᶕθഖ↚ ᴾ ᰛҁу߃ቅᆜޣᒪ㓝Ⲻ⭩䈭㺞ṲȾ Please note: Successful applicants with tuition places offered will be notified by post in early January 2017 for the January intake. Tuition place will only be offered if there are sufficient students to form a class. Admission is subject to availability of tuition places for the subsequent intakes. There is no intake in May & June due to term break. September is the last intake as the tuition term ends in mid-September/ mid-October (depending on the levels). However, there will be no intake for Primary 6 as tuition classes will end in mid-September. Reg No. 199202625K ᔶ䈴ᰛᵕ ā ᒪ ᴾㅢ ઞδԁӄ ᴾ ᰛ㠩 ᰛε δਠ䲆ӄ൞ ᒪ ᴾ ᰛⲺ⭩䈭㺞Ṳε Commencement of Programme –3 rd week (from 16 to 22 January 2017) (For applications received by 16 December 2016 only) ϾףĢՎȗƂĜ CDAC

ß P> A× H ´ E µ CDAC Tuition Programme (Primary) … Parents/Forms...ß P> A× H ´ E µ CDAC Tuition Programme (Primary) 2017 ¸ +iB- How to Apply B- r  vM6

  • Upload
    others

  • View
    2

  • Download
    0

Embed Size (px)

Citation preview

Page 1: ß P> A× H ´ E µ CDAC Tuition Programme (Primary) … Parents/Forms...ß P> A× H ´ E µ CDAC Tuition Programme (Primary) 2017 ¸ +iB- How to Apply B-  r  vM6

CDAC Tuition Programme (Primary) 2017

How to Apply

Please mail the application form and required photocopied documents to CDAC Secretariat or any CDAC Centre

CDAC Building, 65 Tanjong Katong Road, Singapore 436957 CDAC Secretariat Office Hours: Monday to Thursday: 8.30 am to 6.00 pm Friday: 8.30 am to 5.00pm Saturday: 8.30 am to 1.00 pm CDAC Student Education & Development Dept Hotline: 6603 5555

2016 11 11 12 24 31

Operating Hours of CDAC Centres Monday to Friday: 1.00 pm to 10.00 pm Saturday & Sunday: 10.00 am to 5.00 pm Closed on 11 November 2016, 24 and 31 December 2016 and Public Holidays Incomplete application form or application form without required documents will NOT be processed

CDAC Centre Address CDAC Centre Address Ang Mo Kio Blk 201 Ang Mo Kio Avenue 3 #01-1648 S560201

Tampines Blk 158 Tampines Street 12 #01-77 S521158 ( Centre is temporarily closed: 20/10/16 – 2/1/17)

Bedok Blk 138 Bedok North Street 2 #01-185 S460138

Bukit Panjang Blk 270 Bangkit Road #01-22 S670270 Tanjong Katong 65 Tanjong Katong Road, Blk B Level 1 S436957

Jurong Blk 421 Jurong West Street 42 #01-1045 S640421 Toa Payoh No. 381 Lorong 1 Toa Payoh Level 2, OnePeople.sg Building S319758

Punggol Blk 512 Hougang Avenue 10 #01-67 S530512 Woodlands Blk 680 Woodlands Avenue 6 #01-764 S730680

Redhill Blk 83 Redhill Lane #01-85 S150083 Yew Tee Blk 627 Choa Chu Kang Street 62 #01-160 S680627

Sengkang Blk 321B Anchorvale Drive #01-196 S542321 Yishun Blk 145 Yishun Street 11 #01-41 S760145

Missed the Application Date: Students who meet the eligibility criteria may apply to join the Tuition Programme at any point of time but is subjected to places availability. The table below on monthly intake cut-off date is for your reference.

Application form received within: Commencement Month

17/12/2016 – 6/1/2017 February

7/1/2017 – 6/2/2017 March

7/2/2017 – 6/3/2017 April

7/3/2017 – 5/6/2017 July

6/6/2017 – 7/7/2017 August

8/7/2017 – 7/8/2017 September

●●

Please note:

● Successful applicants with tuition places offered will be notified by post in early January 2017 for the January intake. Tuition place will only be offered if there are sufficient students to form a class. ○ Admission is subject to availability of tuition places for the subsequent intakes.

● There is no intake in May & June due to term break. ○ September is the last intake as the tuition term ends in mid-September/ mid-October (depending on the levels). However, there will be no intake for Primary 6 as tuition classes will end in mid-September.

Reg No. 199202625K

Commencement of Programme – 3rd week (from 16 to 22 January 2017) (For applications received by 16 December 2016 only)

CDAC

W1610079_CDAC Form.indd 1 6/10/16 11:47 amW161018 How to Apply_1.indd 1W161018 How to Apply_1.indd 1 12/10/16 2:20 PM12/10/16 2:20 PM

Page 2: ß P> A× H ´ E µ CDAC Tuition Programme (Primary) … Parents/Forms...ß P> A× H ´ E µ CDAC Tuition Programme (Primary) 2017 ¸ +iB- How to Apply B-  r  vM6

Applicant to take note

Eligibility Criteria

Note: Student must meet all eligibility criteria

:

‘CTP’

1 Race / Nationality Student or one of the parents must be a Chinese Singapore Citizen OR Singapore Permanent Resident * Tuition centres indicated as ‘CTP’ will accept students of all races.

2 Gross Monthly Household Income (MHI) / Gross Per Capita Income (PCI)

Gross MHI: $3,300 and below; OR Gross PCI: $900 and below (Note: Chinese student whose Gross MHI is above $3,300 but $4,000 and below or Gross PCI is above $900 but $1,000 and below will be considered if there is availability of tuition places.)

3 Results P1 - P3: 75% and below P4 - P6: 69 % (Band 3) and below

P5 and P6 Foundation English and Foundation Mathematics: No Restriction

4 Student must be a full-time primary student attending a Government/Government-Aided School.

Levels & Subjects :

P1 – P2: English and Mathematics P3: English, Mathematics and Science P4 - P6: Chinese, English, Mathematics, Science, Foundation English and Foundation Mathematics

Tuition Fee

Payment is through POSB/DBS GIRO

:

Gross MHI: $3,300 and below; OR Gross PCI: $900 and below

$8 per subject per month

– Gross MHI: Above $3,300 - $4,000; OR Gross PCI: Above $900 - $1,000

$30 per subject per month

Application for Waiver of Tuition Fees

:

* Students whose families are in financial difficulties may apply for waiver of tuition fee. * Tick in Section III of Part I * Application is subjected to approval

Criterion for Waiver of tuition fee: Gross MHI: $1,900 and below; OR Gross PCI: $650 and below

Tuition Terms & Holidays

Note: The dates indicated are subjected to changes

: – Semester 1 16/1/17 – 30/4/17 – Term Break 1/5/17 – 25/6/17 – Semester 2 27/6/17 – 17/9/17 (P6 only) – 27/6/17 – 15/10/17

Holidays Chinese New Year’s Eve, Fourth Day of Chinese New Year, Teachers’ Day and scheduled Public Holidays

Supporting Documents

1 Birth Certificate (BC)/NRIC (both sides)/Certificate of Singapore Citizenship/Re-Entry Permit of ALL family members (including the student) which you have filled in the application form

2 1st page of POSB/DBS passbook (contains personal particulars of Depositor, refer to GIRO Application Form for acceptable accounts)

3 Latest academic result slip

4 Income Documents of Parents/ Guardian & family members living at the same address:

Employed: CPF Contribution History for the past 12 months or latest 3 months’ computerised payslips bearing company stamp/letterhead

Self-employed / Sole Proprietor: Form B consolidated statement/Notice of Assessment and CPF Contribution History for the past 12 months and complete the Declaration of Income Status – Refer to Page 4 of the application form

Others – Housewife, part-time worker, odd-job worker, one who is employed but without payslip, retiree or unemployed person: CPF Contribution History for the past 12 months and complete the Declaration of Income Status – Refer to Page 4 of the application form

Rental Income: Tenancy agreement 5 Other documents (if applicable): Death Certificate, Decree Nisi (with details on custody and maintenance), Copy of Prison visit card/Notice of admission from Singapore Prison Service, Medical documents, Letter of Retrenchment/Termination, Outstanding bank loan (excluding housing loan that is repaid through CPF savings) and Outstanding bills

W1610188 Applicant take note_p2.indd 1W1610188 Applicant take note_p2.indd 1 12/10/16 2:45 PM12/10/16 2:45 PM

Page 3: ß P> A× H ´ E µ CDAC Tuition Programme (Primary) … Parents/Forms...ß P> A× H ´ E µ CDAC Tuition Programme (Primary) 2017 ¸ +iB- How to Apply B-  r  vM6

AVAILABLE TUITION CENTRES IN 2017 Offer Primary 1 to 6 Tuition

Tuition Days & Time Monday to Friday: 7.30pm - 9.00pm Saturday (am): 9.00am - 10.30am & 10.45am - 12.15pm Saturday (pm): 2.00pm - 3.30pm & 3.45pm - 5.15pm

Area Tuition Centre Address Tuition Day / Time (subject to changes)

Ang Mo Kio Ang Mo Kio Pri 20 Ang Mo Kio Avenue 3 Saturday (am)

Da Qiao Pri CTP 8 Ang Mo Kio Street 54 Thursday, Saturday (am)

Bedok Fengshan Pri CTP 307 Bedok North Road Monday, Thursday, Saturday (am)

Bukit Batok Bukit View Sec (P4 – P6 only) 16 Bukit Batok Street 21 Saturday (am)

Keming Pri CTP 90 Bukit Batok East Avenue 6 Saturday (am & 12.45pm -2.15pm)

Bukit Merah Radin Mas Pri CTP 1 Bukit Purmei Avenue Wednesday, Saturday (am)

Bukit Panjang West View Pri CTP 31 Senja Road Monday, Wednesday & Friday

(6.00pm – 7.30pm) Zhenghua Pri CTP

(P3 – P6 only) 9 Fajar Road Saturday (8.30am – 10.00am &

10.15am – 11.45am)

Choa Chu KangChua Chu Kang Pri CTP 20 Choa Chu Kang Avenue 2 Tuesday & Friday

(6.00pm – 7.30pm), Saturday (am)

Clementi/West Coast Pei Tong Pri CTP 15 Clementi Avenue 5 Friday (2.30pm – 4.00pm &

4.15pm – 5.45pm), Saturday (8.00am - 9.30am, 9.45am -11.15am & 11.30am - 1.00pm)

Qifa Pri CTP 50 West Coast Avenue Saturday (am)

Geylang/Kallang

CDAC Building CTP 65 Tanjong Katong Road Monday, Tuesday, Thursday, Friday, Saturday (am)

Hougang/Sengkang Hougang Pri CTP 1 Hougang Street 93 Tuesday, Thursday, Saturday (am)

Rivervale Pri CTP 80 Rivervale Drive Saturday (am), Sunday (9.00am - 10.30am & 10.45am - 12.15pm)

Seng Kang Pri CTP 21 Compassvale Walk Saturday (am)

Yuying Sec (P4 – P6 only) CTP 47 Hougang Avenue 1 Saturday (pm)

Continue on the next page

W1610188 Available Tuition_p3.indd 1W1610188 Available Tuition_p3.indd 1 12/10/16 2:48 PM12/10/16 2:48 PM

Page 4: ß P> A× H ´ E µ CDAC Tuition Programme (Primary) … Parents/Forms...ß P> A× H ´ E µ CDAC Tuition Programme (Primary) 2017 ¸ +iB- How to Apply B-  r  vM6

Collaborative Tuition Programme CTP

CTP

The Collaborative Tuition Programme (CTP) is jointly organised by Chinese Development Assistance Council (CDAC), The Eurasian Association, Singapore (EA), Singapore Indian Development Association (SINDA) and Yayasan MENDAKI. The centres with ‘CTP’ offer tuition to students of all races. The tuition fee payable by each student is subjected to the amount of subsidy granted by the respective Self-Help Groups.

AVAILABLE TUITION CENTRES IN 2017 Offer Primary 1 to 6 Tuition

Tuition Days & Time Monday to Friday: 7.30pm - 9.00pm Saturday (am): 9.00am - 10.30am & 10.45am - 12.15pm Saturday (pm): 2.00pm - 3.30pm & 3.45pm - 5.15pm

Area Tuition Centre Address Tuition Day / Time (subject to changes)

Potong Pasir Potong Pasir CC CTP 6 Potong Pasir Avenue 2 Saturday (am)

Queenstown New Town Pri CTP 300 Tanglin Halt Road Saturday (am)

Sembawang Sembawang Pri CTP 10 Sembawang Drive Tuesday, Thursday, Saturday (am)

Tampines Gongshang Pri CTP 1 Tampines Street 42 Monday & Wednesday (7.00pm – 8.30pm), Saturday (am)

Pasir Ris Sec (P4 – P6 only) 390 Tampines Street 21 Friday, Saturday (am)

Toa Payoh Toa Payoh East CC CTP 160 Lorong 6 Toa Payoh Monday, Wednesday, Friday, Saturday (pm)

Whampoa Whampoa CC (P4 – P6 only) CTP

300 Whampoa Drive Wednesday (6.00pm – 7.30pm & 7.45pm – 9.15pm)

Woodlands Admiralty Pri CTP 11 Woodlands Circle Monday, Tuesday, Wednesday & Thursday (6.30pm – 8.00pm)

Evergreen Pri 31 Woodlands Circle Tuesday & Thursday (7.00pm - 8.30pm), Saturday (am)

Fuchun Pri CTP 23 Woodlands Avenue 1 Saturday (am)

Greenwood Pri 11 Woodlands Drive 62 Saturday (am)

Qihua Pri CTP 5 Woodlands Street 81 Wednesday, Saturday (am)

Yishun Huamin Pri 21 Yishun Avenue 11 Saturday (am)

Yishun Pri CTP 500 Yishun Ring Road Saturday (am)

W1610188 Available Tuition_p4.indd 1W1610188 Available Tuition_p4.indd 1 12/10/16 2:50 PM12/10/16 2:50 PM

Page 5: ß P> A× H ´ E µ CDAC Tuition Programme (Primary) … Parents/Forms...ß P> A× H ´ E µ CDAC Tuition Programme (Primary) 2017 ¸ +iB- How to Apply B-  r  vM6

1

APPLICATION FORM ( PRIMARY)

PART I STUDENT’S INFORMATION

Section I: Student’s Particulars ( Please complete every column.)

Name & NRIC No. (As in Birth Cert./NRIC)

Name _____________________________________________________________________

BC / NRIC No. ________________________________

Date & Country of Birth Date of Birth: ____________________________________ ( DD / MM / YYYY)

Country of Birth: ____________________________________

Citizenship Singapore Citizen Singapore PR

Gender Male Female

Race Chinese Eurasian Indian Malay

Others ( Please state) _________________________

Home Address Blk : ________ # ________-____________

Street: _________________________________________________________________________

Postal Code ____________________

Mobile No. Self

Current School (2017)

Level & Stream (2017) Level: _______________________ Stream: ____________________

Special Learning Condition (if any)

( Please state) _______________________________________________________________

Section II: Tuition Centre & Subject(s) applying for

Choice of Tuition Centre 1. __________________________________________________________________________

2. __________________________________________________________________________

Tick the subject(s) applying for and indicate the latest academic result.

English

Foundation English

Mathematics

Foundation Mathematics

Chinese P4 - P6 Science P3 - P6

( _________ % / Band or Grade _________ )

( _________ % / Band or Grade _________ )

( _________ % / Band or Grade _________ )

( _________ % / Band or Grade _________ )

( _________ % / Band or Grade _________ )

( _________ % / Band or Grade _________ )

Section III: Application for Tuition Fee Waiver

I would like to apply for tuition fee waiver. (CDAC – SFCCA Bursary recipient is waived automatically)

W1610188 Application Form_p5-9.indd 1W1610188 Application Form_p5-9.indd 1 12/10/16 4:27 PM12/10/16 4:27 PM

Page 6: ß P> A× H ´ E µ CDAC Tuition Programme (Primary) … Parents/Forms...ß P> A× H ´ E µ CDAC Tuition Programme (Primary) 2017 ¸ +iB- How to Apply B-  r  vM6

2

PART II FAMILY’S INFORMATION

Section I: Information on Parents/Guardian(s)

Name of Parent (as in NRIC)

Father – Age ( )

________________________________________________

Mother – Age ( )

________________________________________________

NRIC No. & Country of Birth

/ NRIC No.: ____________________________

/Country of Birth: _________________________

/ NRIC No.: ____________________________

/Country of Birth: _________________________

Nationality

S’pore Citizen S’pore PR Others ( Please state):

___________________________________________

S’pore Citizen S’pore PR Others ( Please state):

_____________________________________________

Race

Chinese Others ( Please state):

Chinese Others ( Please state):

Contact No. Home:

Mobile:

Home:

Mobile:

Employment /Occupation

Occupation & Position Held:

________________________________________________

Salary ( Before CPF contribution)

$ ______________________________

Other Income Including Maintenance Fee)

$ ______________________________

Name of Employer/ Company ( including self-employed person) ________________________________________________

Company/Trade Address

Telephone No.

Occupation & Position Held:

________________________________________________

Salary ( Before CPF contribution)

$ ______________________________

Other Income Including Maintenance Fee)

$ ______________________________

Name of Employer/ Company ( including self-employed person) ________________________________________________

Company/Trade Address

Telephone No.

Section II: Information on other family members (to exclude applicant and parents) staying in the same household Name (as in NRIC)

NRIC No. Relationship with Applicant

Occupation & Company / School

Gross Monthly Income

1.

2.

3.

4.

5. 6.

Othermem

bers

W1610188 Application Form_p5-9.indd 2W1610188 Application Form_p5-9.indd 2 12/10/16 4:27 PM12/10/16 4:27 PM

Page 7: ß P> A× H ´ E µ CDAC Tuition Programme (Primary) … Parents/Forms...ß P> A× H ´ E µ CDAC Tuition Programme (Primary) 2017 ¸ +iB- How to Apply B-  r  vM6

3

Section III: Other Information ( Tick if applicable)

(A) Housing Type HDB Flat:

1 Room 2 Room 3 Room 4 Room 5 Room E-Flat EC Others ( Please state) :____________

Non HDB Flat: Condominium Landed Property

Others ( Please state : __________________

(B) House Ownership

Owned ( Please state year of purchase) Fully Paid Year of Purchase:____________

Monthly Housing Loan:

Cash $ ____________ CPF $_______________

Inherited Property

Rented: Rental per month: $ _______________

Others ( Please state) : ______________________

(C) Car Ownership Yes No Car owner please provide details)

Motorcycle ompany Van ompany Car ompany Lorry ompany Passenger Bus

No of seats: ___________ Private Car ( Please provide details)

New Car Second hand car

Car plate No.: _____________ Car Model:_____________

Year of Purchase:_____ Monthly Loan:

Monthly Expenses (including loan):

Reason : __________________________________________________

(D) Maid Yes No

Reason for hiring maid: _________________________________________________________________

Other Sources of IncomeMaintenance fee: $ ___________

Rental income: $ ___________

/ :

Monthly pay-out from CPF Retirement Account/Pension $____________

:

Insurance compensation (e.g. Dependants’ Protection Scheme): $___________

Others (

Please specify income source and amount received.): Income source: _____________________________

Amount $______________________________

(F) Is your family receiving financial assistance from other organisations or persons?

Yes No

( , If ‘Yes’, please provide the following information and attach the relevant documentations.)

Name of Organisation / Person Telephone No. Type of assistance and Amount Period

1.

2.

(G) Does your family have any outstanding bills? If yes, please provide details in the table below and attach a copy of the arrears indicated.

Rental / Housing Loan Instalment Does not include CPF for housing loan $

Utilities $

elephone charges $

Service & Conservancy charges $

Medical fees / Banks & Other Loans $

Other outstanding bills ( please specify) $

Total Amount $

W1610188 Application Form_p5-9.indd 3W1610188 Application Form_p5-9.indd 3 12/10/16 4:27 PM12/10/16 4:27 PM

Page 8: ß P> A× H ´ E µ CDAC Tuition Programme (Primary) … Parents/Forms...ß P> A× H ´ E µ CDAC Tuition Programme (Primary) 2017 ¸ +iB- How to Apply B-  r  vM6

4

Declaration of Income Status ( complete where applicable)

(A) Declaration of Self-Employment

Name NRIC No.

( ) Nature of Self-Employment (e.g. retail business, hawker, taxi driver, etc.)

Latest Annual Income

Signature/Date

1.

2.

3.

4.

(B) Declaration of Employment without income documents/Part-Time Employment

Name NRIC No. )

Occupation (for odd job, please describe job nature)

Reason(s) for not producing income documents

Gross Monthly Income

Signature/Date

1.

2.

3.

4.

(C) Declaration of Unemployment

Name NRIC No. Unemployment since

(mth/yr)

()

Reason for unemployment (e.g. housewife, retrenched, resigned, retired etc.)

Signature/Date

1. __________/___________

( mth) ( yr)

2. __________/___________

( mth) ( yr)

3. __________/___________

( mth) ( yr)

4. __________/___________

( mth) ( yr)

(D) Declaration of Maintenance Fee

Name NRIC No. Have not received maintenance fee from my ex-spouse since (mth/yr) Signature/Date

1. ____________ ( mth) _____________ ( yr)

2. ____________ ( mth) _____________ ( yr)

W1610188 Application Form_p5-9.indd 4W1610188 Application Form_p5-9.indd 4 12/10/16 4:27 PM12/10/16 4:27 PM

Page 9: ß P> A× H ´ E µ CDAC Tuition Programme (Primary) … Parents/Forms...ß P> A× H ´ E µ CDAC Tuition Programme (Primary) 2017 ¸ +iB- How to Apply B-  r  vM6

5

PART III PARENT’S DECLARATION AND AUTHORISATION

Please read the following carefully and tick accordingly.

(Application form will be returned if any of the columns are not ticked )

I declare the information provided in this application form and supporting documents are true. If the information is found to be untrue and incorrect, my child’s tuition will be terminated.

I fully understand and agree that the personal information which I have provided may be disclosed to other agencies or individuals for the purpose(s) stated. I trust that the information will strictly be used for the purpose(s) of related assistance schemes and programmes. CDAC also reserves the right to use this information for publicity purposes as well as for sending alerts and updates of related events and activities through digital and non-digital means.

I agree and authorise CDAC to request for or verify information on my child and family from the Ministry of Education and any other entity when necessary.

I agree to CDAC using any video, photograph or audio recording taken of my child or my family during any activities under the tuition programme for any publicity purposes by CDAC.

I authorise CDAC to deduct my child’s monthly tuition fees from my Bank Account. I undertake to maintain sufficient funds in my Account for the monthly tuition fees deduction on the 2nd of every month. I understand that my child’s tuition could be suspended if the GIRO deduction failed for two consecutive months. (Note: Even if my child is under Fee Waiver, I must tick this column. I understand that CDAC processes Fee Waiver applications on a yearly basis and that these applications are not guaranteed approval every year.)

If my application is successful, I will accept the tuition place(s) offered by the CDAC which is/are based on my application. I will ensure that my child observes CDAC’s rules and regulations closely. I agree that CDAC reserves the rights to suspend my child based on disciplinary ground.

I understand that the CDAC Tuition Programme adopts an auto-promotion scheme. Unless I withdraw my child from the Tuition Programme by writing, he/she will be automatically promoted to the next tuition level each year.

I know that CDAC will take into consideration other assets such as property and car owned by my household in assessing the needs of my child for the programmes/schemes applied for.

I declare that I have read and understand the terms and conditions.

Name and Signature of Parent/Guardian

:

Application Submission Date

:

W1610188 Application Form_p5-9.indd 5W1610188 Application Form_p5-9.indd 5 12/10/16 4:27 PM12/10/16 4:27 PM

Page 10: ß P> A× H ´ E µ CDAC Tuition Programme (Primary) … Parents/Forms...ß P> A× H ´ E µ CDAC Tuition Programme (Primary) 2017 ¸ +iB- How to Apply B-  r  vM6

W1610188 Application Form_p5-9.indd 6W1610188 Application Form_p5-9.indd 6 12/10/16 4:27 PM12/10/16 4:27 PM

Page 11: ß P> A× H ´ E µ CDAC Tuition Programme (Primary) … Parents/Forms...ß P> A× H ´ E µ CDAC Tuition Programme (Primary) 2017 ¸ +iB- How to Apply B-  r  vM6

GIRO APPLICATION

Part 1: For Account Depositor’s Completion (There should be no amendments, cancellations or use of correction pen on this page)

BC / NRIC No. of Student

Name of Student

( Please tick below ) Account to be debited Name of Bank ( 9 digits for POSB Account ) □ POSB ( 10 digits for DBS Account ) □ DBS □ Types of Account Name(s) of Depositor(s) : □ Personal □ Joint-Alternate 1. _________________________________________________________ □ Joint □ Current 2. _________________________________________________________

(Unacceptable Accounts : Trust A/C, First A/C, Save-As-You-Earn A/C and A/C holder below 18 years old) ( )

Declaration : NRIC No(s). of Depositor(s) : 1. 2.

Signature(s) / Thumb Impression(s) as in bank’s record

Thumb impression must be done at the Bank

Signature / Thumb impression for

Personal / Current Account OR

1st signatory / thumb impression of Joint-Alternate/ Joint Account

2nd signatory / thumb impression for Joint-Alternate/Joint Account

Note: Deduction on 2nd of every month will be reflected as ‘SHG’ in your passbook/statements. ’

Part 2: For Official Use Only Bank Branch CDAC’s A/C No.

7 1 7 1 0 3 3 0 3 3 0 0 9 8 0 2 2

Bank Branch Depositor's A/C No. Reference No. of Student (BC No.)

Part 3: For Financial Institution's Completion (# Delete where applicable) To: Billing Organisation This application is hereby REJECTED for the following reason(s): □ Signature/ Thumb impression # differs from Financial Institution's records □ Wrong account number □ Signature/ Thumb impression # incomplete/ unclear # □ Amendments not countersigned by customer □ Account operated by signature/ Thumb impression # □ Others: _________________________________ ___________________

_________________

_____________

Name of Approving Officer Authorised Signature Date

I/We hereby instruct the POSB or DBS bank to process CDAC’s instruction to debit my/our account for the tuition fees. I/We will ensure that sufficient funds will be maintained for the monthly debit on the 2nd of each month. If my/our account has insufficient funds, POSB or DBS Bank will at its discretion impose charges accordingly. The authorisation will remain in force until it is revoked by me/us in writing.

CDAC

W1610079_CDAC Form.indd 1 6/10/16 11:47 am

W1610079_CDAC Form.indd 11 6/10/16 11:47 amW1610188 GIRO_10.indd 1W1610188 GIRO_10.indd 1 12/10/16 2:26 PM12/10/16 2:26 PM

Page 12: ß P> A× H ´ E µ CDAC Tuition Programme (Primary) … Parents/Forms...ß P> A× H ´ E µ CDAC Tuition Programme (Primary) 2017 ¸ +iB- How to Apply B-  r  vM6

W1610188 Application Form_p5-9.indd 6W1610188 Application Form_p5-9.indd 6 12/10/16 4:27 PM12/10/16 4:27 PM