UEN: 199409389H BRN: 199409389H

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Student Application Form (INTERNATIONAL STUDENTS)
International DIRECT

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Student’s Name: ___________________ Intake Month: ___________ Intake Month/Year: ________________ Intake Month: ___________

International LOCAL TRANSFER (including dependent pass holders)

Student Application Form (INTERNATIONAL STUDENTS)

Request for exemptions with highest qualification? The complete application package should be returned to：Kaplan Higher Education Academy Pte Ltd Kaplan City Campus @ Wilkie Edge, 8 Wilkie Road, #02-01, Singapore 228095 Or SCANNED and EMAILED to apply.sg@kaplan.com and the respective Country Manager

Language Programs
Diploma in Professional Business English

Certificate in Foundation Studies
Certificate in Foundation Studies

Kaplan Global Diploma
Diploma in Commerce Business Administration Financial Management Diploma in Communication Management Management Information Technology Accountancy Studies Human Resource Management

Kaplan Higher Education Academy Diploma Programs

Partner University Degree Programs (please also fill in the University Application Forms)

(Please turn over for options)

KHEA Student Appln Form V8 (INTERNATIONAL) –01 Oct 2012

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Murdoch University, Australia (Please specify major: ___________________________________) (Please specify major: ____________________________________) (Please specify major: ____________________________________) (Please specify major: ____________________________________)

of Science

Northumbria University, UK Bachelor of Arts (Hons) in Business with Master of Science in Business with

(Please specify major: _________________________________) (Please specify major: _________________________________)

University College Dublin, National University of Ireland Dublin (Please specify major: _________________________________) Master of Science (Please specify major: _________________________________) University of Portsmouth, UK (Hons) Accountancy and Financial Management

Other Programs:
University/Institution:_______________________________________________________________ Program name:____________________________________________________________________

Please note that incomplete information for any of the fields below will result in a non-processing of this application.
1． Personal Details Name in English as in Passport or Identity Card (Underline Surname) Name in Chinese (if Applicable) Gender (please tick) Religion

Marital Status (please tick) Birth Certificate No Date of Birth Age Passport No FIN No. (if applicable) Nationality

DD / MM / YY
Home Country Address Home Country Tel Mobile No. Email Address

Name of Emergency Contact Person (Immediate family members only)

Relationship

Contact No.

KHEA Student Appln Form V8 (INTERNATIONAL) –01 Oct 2012

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2． Information Required for the Processing of a Student’s Pass A. Applicant’s Natural Parents and/or Step Parents Full Name Relationship: (as in travel document)

Nationality

Residential Status in Singapore (cancel appropriately): S’pore citizen/ S’pore Permanent Resident – NRIC: ________________ Resident (Long Term Pass, Work Pass, Dependent Pass etc) -- FIN No.:_______________

Occupation

Date of Birth: DD Full Name (as in travel document) Relationship:

/ MM / YY
Nationality

None of the Above (please tick box) □ Residential Status in Singapore (cancel appropriately): S’pore citizen/ S’pore Permanent Resident – NRIC: ________________ Resident (Long Term Pass, Work Pass, Dependent Pass etc)

Occupation

Date of Birth: DD Full Name (as in travel document) Relationship:

/ MM / YY
Nationality

-- FIN No.:_______________ Occupation

None of the Above (please tick box) □ Residential Status in Singapore (cancel appropriately): S’pore citizen/ S’pore Permanent Resident – NRIC: ________________ Resident (Long Term Pass, Work Pass, Dependent Pass etc) None of the Above (please tick box)

Date of Birth: DD

/ MM / YY

-- FIN No.:_______________

□
Occupation

B. Applicant’s Spouse (if applicable) Full Name Relationship : (as in travel document)

Nationality

Residential Status in Singapore (cancel appropriately): S’pore citizen/ S’pore Permanent Resident – NRIC: ________________ Resident (Long Term Pass, Work Pass, Dependent Pass etc) None of the Above (please tick box)

Date of Birth: DD

/ MM / YY

-- FIN No.:_______________

□
Occupation

C. Applicant’s Siblings (if applicable) Full Name Relationship: (as in travel document)

Nationality

Residential Status in Singapore (cancel appropriately): S’pore citizen/ S’pore Permanent Resident – NRIC: ________________ Resident (Long Term Pass, Work Pass, Dependent Pass etc)

Date of Birth: DD Full Name (as in travel document) Relationship:

/ MM / YY
Nationality

-- FIN No.:_______________ Occupation

None of the Above (please tick box) □ Residential Status in Singapore (cancel appropriately): S’pore citizen/ S’pore Permanent Resident – NRIC: ________________ Resident (Long Term Pass, Work Pass, Dependent Pass etc) None of the Above (please tick box)

Date of Birth: DD

/ MM / YY

-- FIN No.:_______________

□

KHEA Student Appln Form V8 (INTERNATIONAL) –01 Oct 2012

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3． Education and Qualification – in chronological order from Secondary/High School( Certified copies of proof (native and English translated) must be attached.) Name of School Country State/Province Language of Instruction Period of Study Highest Educational Qualification Academic/ Professional (Eg Chinese, English) From To (if Honours degree, pls state class/division) DD / MM / YY DD / MM / YY DD / MM / YY

DD / MM / YY DD / MM / YY DD / MM / YY

4． Applicant’s Employment – in chronological order ( if applicable) Name of Company Country From

Period of Working To

Position Held

Nature of Duties

DD / MM / YY DD / MM / YY

DD / MM / YY DD / MM / YY
Monthly Average Income for Past 6 months: Current Savings (Eg Fixed Deposit) Monthly Average Income for Past 6 months: Current Savings (Eg Fixed Deposit) in local currency No

5． Applicant’s Financial & Support Details (to be completed by applicant from Visa-required Countries) Applicant Monthly Average Income for Past 6 months: Applicant’s Spouse Current Savings (Eg Fixed Deposit) Applicant’s Father Monthly Average Income for Past 6 months: Applicant’s Mother

Current Savings (Eg Fixed Deposit) in local currency Other Financial Support from Immediate Family Members

Yes (Pls furnish details on a separate sheet)

6.

Confidentiality Clause This information you have provided will be kept confidential and used solely for communicating with you.

7. Withdrawal and Refund Policies Kaplan Higher Education Academy shall inform the student immediately within 3 working days if: i. iii. v. it fails, for any reason, to commence the course on the course commencement date it fails, for any reason, to complete the course by the course completion date. The student pass is rejected by Immigration & Checkpoints Authority (ICA) ii. it terminates the course, for any reason, prior to the course commencement date. iv. it terminates the course, for any reason, prior to course completion date.

KHEA Student Appln Form V8 (INTERNATIONAL) –01 Oct 2012

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% of the aggregate amount of the course fees paid [100%] [70%] [30%] [10%] [0%]

If student’s written notice of withdrawal is received (“Maximum Refund”) More than [60] days before the course commencement date Before, but not more than [60] days before the course commencement date Before, but not more than [14] days before the course commencement date Before, but not more than [7] days before the course commencement date On or after the course commencement date

Kaplan Higher Education Academy shall, within 7 working days of notifying the student in writing of above circumstances (i) to (iv), provide the student with information and details of the alternative confirmed course arrangement to allow the student to make timely and appropriate decision on the alternative arrangement. Kaplan Higher Education Academy offers a 7-day cooling off period to students who wish to withdraw after signing their student contract. Students will receive the maximum refund of the course fees if they withdraw within 7 days of signing the student contract. All withdrawal requests must be presented to Kaplan Higher Education Academy officially in writing. In the event that a student wishes to withdraw from the program, the application fee and the administrative fee are not refundable. Students are liable to pay (where applicable) fees that are imposed by the government authorities or other external partners. For more information on Fee Protection Scheme and refund policy, please refer to www.cpe.gov.sg 8. Pre-Course Counseling Checklist I confirm I have been advised on/ provided information of the following: 1. 2. Information of the school (accreditation, location, facilities etc) Information on Singapore – for international students only (About Singapore, Relevant Immigration rules and Relevant laws of the Republic of Singapore) Course Information (Name of award, awarding body, course duration, outlines) Entry Requirements Fee Information Application Procedures & Modes of Payment Withdrawal and Refund Policies Information on Council for Private Education Information on Fee Protection Scheme Page 5 of 7

Tick accordingly

3. 4. 5. 6. 7. 8. 9.

KHEA Student Appln Form V8 (INTERNATIONAL) –01 Oct 2012

10. Information on Standard Student Contract 9. Application Document Checklist The completed application form must be accompanied by the following items: 1. 2. 3. 4. Copy of Passport (page with personal details) and notarised copies of Birth Certificate & Family Card, if applicable, (Native & English translated) Certified copies of diploma, certificate and transcripts (Native and English translated language) Application Fee - $ 481.50 (inclusive of GST; non-refundable) - pls provide *Proof of Payment for Telegraphic and/or Bank transfers Passport sized photographs (on WHITE background) Payment methods & Payable Account Details For payment by cheque(s), please make payable to Kaplan Higher Education Academy Pte Ltd. For payment by *Telegraphic Transfer, you may refer below for the bank account information. Bank Name : DBS Bank Bank Address : 6 Shenton Way, DBS Building, Singapore 068809 Beneficiary's Name : Kaplan Higher Education Academy Pte Ltd Account No/ Swift Code : 001-900452-7 / DBSSSGSG Beneficiary's address : 51 Cuppage Road #03-01 Singapore 229469

Tick Accordingly

KHEA Student Appln Form V8 (INTERNATIONAL) –01 Oct 2012

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BRN: 199409389H

STUDENT INFORMATION/UPGRADE/REFERRAL FORM
Please provide the following details:
Course Name and awarding University/Institution: Intake No:

Full Name (as it appears on passport/identity card):

NRIC/Passport/FIN:

Contact Number:

Fill in the following if you are: Referred by a Kaplan Official Student Recruitment Agent

Name of Agency: ___________________________________________________________________________________ Referred by a Kaplan Existing Student or Alumni Full name of student: _________________________________________________________________________________ Contact number: _____________________________________________________________________________________ Programme and awarding University/Institution of Existing Student or Alumni: ___________________________________________________________________________________________________ Intake number: _____________________________________________________________________________________ I am a new student and was not referred to Kaplan by an existing student or recruitment agent. Declaration: I hereby apply for admission to the above-mentioned programs. I declare that the information given in this form is true and complete. I understand that if falsified information is submitted, admission will be rescinded. I have read the program prospectus and understand that progression into the top-up degree program is subject to University’s final approval. I will comply with all the conditions, refund policy, rules and regulations of Kaplan Higher Education Academy Pte Ltd, the University and the Immigration and Checkpoints Authority of Singapore.

Applicant Signature

Date

For official use Remarks:

____________________________________________________________________

Name of verifying personnel/ Designation: _________________________________________________________________

Signature

Date

KHEA Student Appln Form V8 (INTERNATIONAL) –01 Oct 2012

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