华助会学生辅助计划 2014201 444 cdac student assistance … 2014.pdf · cdac –sfcca...

STUDENT EDUCATION & DEVELOPMENT DEPARTMENT, CDAC BUILDING 65 TANJONG KATONG ROAD, SINGAPORE 436957 TEL: 6603 5588 FAX: 6841 4881

华助会学生辅助计划华助会学生辅助计划华助会学生辅助计划华助会学生辅助计划 2012012012014444

CDAC STUDENT ASSISTANCE & SUPPORT SCHEME 2014 ��华助会华助会华助会华助会----宗乡总会助学金宗乡总会助学金宗乡总会助学金宗乡总会助学金 ��豁免补习费豁免补习费豁免补习费豁免补习费 ��活动费津贴活动费津贴活动费津贴活动费津贴

CDAC–SFCCA Bursary Tuition Fee Waiver Activity Fee Subsidy

华社自助理事会华社自助理事会华社自助理事会华社自助理事会((((华助会华助会华助会华助会)))) 成立于 1992 年 5 月 22 日，华助会是一个由华族社群发起，为新加坡华族社群服务的社群自助团体。宗旨宗旨宗旨宗旨培育和发展华族社群的潜能，为多元种族新加坡的成功作出贡献。愿景愿景愿景愿景创造一个自力更生、力争上游、互助扶持、团结与和谐的社群。培育学生培育学生培育学生培育学生为不同进度的学生制定特别的课程，同时提供援助和津贴，协助他们得到全方位的发展，争取卓越表现。 � 补习计划补习计划补习计划补习计划 (适合成绩欠佳的中小学生) � 优优优优苗培育苗培育苗培育苗培育(适合成绩中上有潜能争取更好成绩的中小学生) � 学术与非学术性的益智课程和活动学术与非学术性的益智课程和活动学术与非学术性的益智课程和活动学术与非学术性的益智课程和活动 (让学生有全方位发展的机会) 服务对象服务对象服务对象服务对象 � 本身或家长是新加坡公民或永久居民的在籍华族学生 � 家庭总收入在扣除公积金前不超过$3,000 或人均收入不超过$800 都可以参加上述计划及活动，享有华助会的津贴 [[[[每月每月每月每月家庭总家庭总家庭总家庭总收收收收入在入在入在入在 $1,500$1,500$1,500$1,500 或或或或人均收入在人均收入在人均收入在人均收入在 $450$450$450$450 以下者以下者以下者以下者，，，，可以申请助学金可以申请助学金可以申请助学金可以申请助学金、、、、豁免补习费豁免补习费豁免补习费豁免补习费和更高的活动费津贴和更高的活动费津贴和更高的活动费津贴和更高的活动费津贴]]]]

CHINESE DEVELOPMENT ASSISTANCE COUNCIL (CDAC) A community self-help group set up on 22 May 1992 by and for the Chinese community in Singapore.

Mission

To nurture and develop the potential of the Chinese community in contributing to the continued success of the multi-racial Singapore.

Vision

A cohesive and resilient community that strives for upward social mobility through self-help and mutual support.

Developing Students

The customised programmes, supported by assistance and subsidy schemes, help students to develop holistically to excel in both academic and non-academic achievements.

� Tuition Programme (targets at academically weak students from Primary 1 to Secondary 5)

� Project Excellence (target at promising Primary and Secondary students)

� Academic and Non-academic Enrichment Programmes (opportunity for holistic development for students)

Target Group

� Student or one of the parents must be a Chinese Singapore Citizen or Permanent Resident

� Gross Monthly Household Income (MHI) not exceeding $3,000 or Monthly Per Capita income (PCI) not exceeding $800 are eligible for the above mentioned programmes which are highly subsidised by CDAC

[MHI not exceeding $1,500 or PCI not exceeding $450 could apply for Bursary, Tuition Fee Waiver and higher Activity Fee Subsidy]

华助会学生辅助计划华助会学生辅助计划华助会学生辅助计划华助会学生辅助计划为低收入家庭的学生提供经济资助，让他们能通过课业和益智等课外进修，得到全面发展；从而激励他们争取更好的表现，让自己和社群受益。 CDAC Assistance and Support Scheme provides financial assistance and additional avenue for the needy students to do better in their studies through attending CDAC tuition and educational programmes. It creates a platform for them to gain holistic development in life and to motivate them to strive for greater achievements to benefit self and the community. 辅助计划辅助计划辅助计划辅助计划 (*(*(*(*助学金助学金助学金助学金、、、、豁免补习费及豁免补习费及豁免补习费及豁免补习费及 90%90%90%90%的活动费津贴的活动费津贴的活动费津贴的活动费津贴))))申请条件申请条件申请条件申请条件

Eligibility for Assistance & Support Scheme (****Bursary, Tuition Fee Waiver & 90% Activity Fee Subsidy) 家庭总收入家庭总收入家庭总收入家庭总收入 Household Income ≤ $1,500 ////人均收入人均收入人均收入人均收入 Per Capita Income ≤ $450 ****申请助学金附带其他条件申请助学金附带其他条件申请助学金附带其他条件申请助学金附带其他条件 Application for Bursary comes with other conditions


��华助会华助会华助会华助会----宗乡总会助学金宗乡总会助学金宗乡总会助学金宗乡总会助学金 CDAC–SFCCA Bursary

申请者须知申请者须知申请者须知申请者须知 Applicants to take note 华助会华助会华助会华助会----宗乡总会助学金宗乡总会助学金宗乡总会助学金宗乡总会助学金 CDAC – SFCCA Bursary 成功的申请者可以利用助学金采购学校必需品、支付交通费、午餐费等，减轻家中负担，在新的学年继续学业。 The Bursary is meant for successful applicants to purchase school necessities, defray transport and meals cost for the new school term. 申请助学金的附加条件申请助学金的附加条件申请助学金的附加条件申请助学金的附加条件 ADDITIONAL CRITERIA FOR BURSARY APPLICANTS

1) 申请者必须是在籍的新加坡政府学校、政府辅助学校、自治学校、自主学校、工艺教育学院、初级学院或高级中学，以及特别学校的学生。 1) Student must be a full-time student attending a Government School, Government-Aided School, Autonomous School, Independent School, Institute of Technical Education (ITE), Junior College (JC), Centralised Institute (CI) or Special Education School (SPED) in Singapore.

2) 品行良好(至少达到“Good”)及有良好(至少“90%”)的上课出席率。 2) Student must have good conduct (at least “Good”) and regular attendance (at least “90%”) in the school.

3) 在 2013/2014 年不能不能不能不能是以下项目的受惠者： - 政府购屋及教育辅助计划(HOPE) - 任何奖、助学金（教育储蓄奖学金和优异助学金除外） - 海峡时报零用钱基金 - 初级学院/高级中学/直通车(5 及 6 年级)教育部经济援助金 - CDC-CCC ITE 助学金/奖学金 3) Student must not be in receipt in any of the following for year

2013/2014: - Home Ownership Plus Education (HOPE) Scheme - Other scholarship or bursary from organisations or schools (excluding Edusave scholarship and Merit Bursary)

- The Straits Times School Pocket Money Fund - JC / CI / Integrated Programme (Year 5 & 6) MOE-FAS - CDC-CCC ITE Bursary / Scholarship 怎样申请怎样申请怎样申请怎样申请 TO APPLY

1) 填妥申请表格的第一部分 - 学生资料学生资料学生资料学生资料（每个申请学生各一份），并据实回答所有的问题。 1) Complete Part I of the application form – Student’s Information (1 set per applicant), answer to the questions listed truthfully.

2) 填妥申请表格的第二部分 - 家庭资料家庭资料家庭资料家庭资料（每个家庭一份表格），并签署适当的宣誓部分。 2) Complete the Part II – Family’s Information (1 set per family), and declare the employment and income status in the relevant portion.

3) 附上所需要的文件副本。 3) Enclose photocopied documents required.

4) 将申请表格及所需文件邮寄至： CDAC Building 65 Tanjong Katong Road Singapore 436957 4) Submit application form and supporting documents to:

CDAC Building 65 Tanjong Katong Road Singapore 436957 所需所需所需所需的文件副本的文件副本的文件副本的文件副本 PHOTOCOPIED DOCUMENTS REQUIRED

1) 学生及同住家庭成员的身份证明学生及同住家庭成员的身份证明学生及同住家庭成员的身份证明学生及同住家庭成员的身份证明：：：： 1) STUDENT AND FAMILY MEMBERS’ IDENTITY DOCUMENTS:

� 学生的出生证/居民证（双面)/新加坡公民证书/新加坡永久居民入境准证 � Student’s Birth Certificate (BC) / NRIC (both sides) / Certificate of Singapore Citizenship / Re-entry Permit � 所有所有所有所有同住家庭成员的居民证(双面)/出生证/新加坡公民证书/新加坡永久居民入境准证 � NRIC (both sides) / BC / Certificate of Singapore Citizenship / Re-entry Permit of ALL family members who are living at the same address

2) 家长家长家长家长////监护人及其他同住家庭成员的收入证明监护人及其他同住家庭成员的收入证明监护人及其他同住家庭成员的收入证明监护人及其他同住家庭成员的收入证明：：：： 2) INCOME DOCUMENTS OF PARENTS’/GUARDIAN & FAMILY MEMBERS LIVING AT

THE SAME ADDRESS: � 全职工作者全职工作者全职工作者全职工作者：过去 6 个月的公积金缴交纪录及最新（以不超过申请日期 3 个月为准）薪金单或由雇主签发的收入证明书（未扣除公积金,包括津贴和加班费的收入） � For working family members: CPF Contribution History for the

past 6 months and latest payslip (within 3 months from the date of application) or employment letter (before CPF contribution, including allowances, maintenance fee and overtime pay)

� 家庭主妇家庭主妇家庭主妇家庭主妇、、、、自雇人士自雇人士自雇人士自雇人士、、、、兼职工兼职工兼职工兼职工、、、、散工散工散工散工、、、、有全职工作但有全职工作但有全职工作但有全职工作但无薪金单无薪金单无薪金单无薪金单、、、、退休或无业者退休或无业者退休或无业者退休或无业者：：：：过去 6 个月的公积金缴交纪录及收入宣誓信–请参阅表格内的项目项目项目项目 VVVV 部分部分部分部分。。。。自雇人士必须附上最新的所得税单 � For housewife, self-employed person, part-time worker, odd-job worker, one who is employed but without payslip, retiree or unemployed person: CPF Contribution History for the past 6 months and complete the Declaration of Income Status – Refer to Section V of the application form. The self-employed person must submit the latest Income Tax Notice of Assessment (NOA).

� 死亡证书、离婚判决书(包括孩子抚养权及赡养费的详情)、监狱探访卡/入狱通知书、医药证件或裁员/解雇通知书 (如有) � Death Certificate, Decree Nisi (with details on custody and maintenance), Copy of Prison visit card/Notice of Admission from Singapore Prison Service, Medical Documents and Letter of Retrenchment/Termination, where applicable.

3) 学生成绩和学校录取证明学生成绩和学校录取证明学生成绩和学校录取证明学生成绩和学校录取证明（（（（只限助学金申请者只限助学金申请者只限助学金申请者只限助学金申请者））））：：：： 3) STUDENT’S RESULT SLIP / LETTER OF ADMISSION (FOR BURSARY

APPLICANTS ONLY): � 最新的成绩单。中一中一中一中一、初级学院初级学院初级学院初级学院////高级中学高级中学高级中学高级中学 1111 年级和年级和年级和年级和工艺教育学院的工艺教育学院的工艺教育学院的工艺教育学院的新生新生新生新生必须附上会考成绩单会考成绩单会考成绩单会考成绩单 � Student’s latest academic result slip. Sec 1, JC/CI Year 1 and ITE

Year 1 student should enclose PSLE, GCE ‘N’/ ‘O’ level examination result slip

� 小一小一小一小一、中一中一中一中一、初级学院初级学院初级学院初级学院////高级中学高级中学高级中学高级中学 1111 年级和工艺教育年级和工艺教育年级和工艺教育年级和工艺教育学院的学院的学院的学院的新生新生新生新生都必须附上学校/学院录取通知 � Pri 1, Sec 1, JC/CI Year 1 and ITE Year 1 students in 2014 should also enclose letter of admission by school or college

4) 学生的银行户头资料学生的银行户头资料学生的银行户头资料学生的银行户头资料： 4) STUDENT’S BANK ACCOUNT DETAILS:

� 学生的邮政储蓄银行/星展银行存折的第一页 � First page of Student’s POSB/DBS passbook

请保留此页以供日后参考

Please read and retain this page for reference


请注意请注意请注意请注意 TO NOTE

1) 华助会将审慎处理所有的申请表格，但是并不保证符合申请条件的申请一定获得批准。所有申请结果将以书面通知。 1) All applications will be considered but eligibility does not guarantee the award of Scheme. Outcome of the application will be notified by post.

2) 华助会保留权力：● 拒绝处理不符合申请要求、不完整的申请表格；● 在发现申请者不诚实填写家庭收入资料时，取消原先批准的申请决定，●包括追讨回已经发放的助学金、终止活动费津贴等；● 利用有限的资源协助最有需要的学生。一旦审核完毕，任何相关询问将不受理。 2) CDAC reserves the right to: ● reject application which does not meet the basic eligibility criteria or which is incomplete; ● request for additional supporting documents; ● demand for a full refund/void disbursement if information provided by applicant is found to be untrue; and ● grant approval to the most deserving applicants. The decision shall be final and no enquiry of the outcome will be entertained. 助学金额助学金额助学金额助学金额 QUANTUM $280 - 小学 $450 - 中学 $580 - 3 年制高中、直通车 5 及 6 年、初级学院以及工艺教育学院 $280 – Primary

$450 – Secondary $580 – Centralised Institute, Integrated Programme Year 5 & 6, Junior College and ITE 如何申请如何申请如何申请如何申请 HOW TO APPLY

• 向校方、华助会中心索取表格，或上华助会网站 :

www.cdac.org.sg 下载表格 • 仔细填写表格，让后请校方推荐盖章 • 在邮寄表格前，再次检查表格，确保填写完整，以及附上所需要的证件 • 根据指定截止日期之前，将表格寄交华助会秘书处 65 Tanjong Katong Road, Singapore 436957

• Obtain application forms from school, CDAC Centres or download from CDAC website: www.cdac.org.sg

• Complete the form carefully and obtain endorsement from school • Check the application form to ensure all columns are filled and required

supporting documents are enclosed before mailing to CDAC • Send in the completed application form to CDAC Secretariat according to

the stipulated closing dates of the various levels Mailing address: 65 Tanjong Katong Road Singapore 436957 附加优惠附加优惠附加优惠附加优惠（成功申请者） ADDITIONAL BENEFITS (SUCCESSFUL APPLICANTS)

a) 自动获得 90%的华助会中活动费津贴（必须事先到中心登记） a) Automatically granted 90% Activity Fee Subsidy (requires pre-registration at CDAC Centres)

b) 免费参加华助会补习班 b) Granted Tuition Fee Waiver 申请申请申请申请日期日期日期日期

WHEN TO APPLY

2014 年就读年级年就读年级年就读年级年就读年级

Level in 2014 申请开放日期申请开放日期申请开放日期申请开放日期 Application opens from:

申请截止日期申请截止日期申请截止日期申请截止日期 Application closes on:

小学 1 至 6 年级/特别学校 1 至 6 年级 Primary 1 to 6 / Special School Junior 1 to 6

08-07-2013 23-08-2013

中学、特别学校(2 至 4 年级)及直通车(2 至6 年级) Secondary ( 2 to 4) , Special School Senior (Year 2

to 4) & Integrated Programme (Year 2 to 6) 初级学院(2年级)、高级中学（2、3年级）及工艺教育学院（2年级）

Junior College (Year 2), Centralised Institute (Year 2 & 3) / ITE (Year 2)

中学 1 和 5 年级 Secondary 1 & 5

‘N’水准成绩放榜后/中学一年级学校分配后 After the release of GCE ‘N’ Level results / Secondary 1 school posting 10-01-2014

工艺教育学院（1 年级） ITE (Year 1) ‘N’水准成绩放榜后

After the release of GCE ‘N’ Level results 28-02-2014

初级学院 / 高级中学（1 年级） Junior College / Centralised Institute (Year 1) 20-01-2014 28-02-2014


��豁免补习费豁免补习费豁免补习费豁免补习费 Tuition Fee Waiver 申请者须知申请者须知申请者须知申请者须知 Applicants to take note 关于华助会补习计划关于华助会补习计划关于华助会补习计划关于华助会补习计划 ABOUT CDAC TUITION PROGRAMME

1) 为中小学的学生提供有系统的小组补习。详细资讯，请参阅华助会网站: www.cdac.org.sg。 1) CDAC provides structured group tuition for Primary 1 to Secondary 5 students. For details, please refer to CDAC website at www.cdac.org.sg.

2) 华助会的大约 50间补习中心遍布全国。 2) CDAC Tuition Classes are conveniently located at about 50 locations nationwide.

3) 合格的教师或专业人教导、除了提供适合的教材和练习，并有教育咨询团定时关注和督导补习班的进度。在补习科目取得显著跃进的学生还可能获颁进步奖项。 3) Coached by trained teachers/qualified individuals. Students will be provided with suitable teaching materials and exercises. Classes are closely monitored by a panel of Education consultants. Students who achieve big improvements in the tuition subjects will be awarded. 如何报名如何报名如何报名如何报名 HOW TO REGISTER

1)

2014 年的补习计划将从 2013 年 11 月起开放给家长申请，表格可在学校、华助会中心索取，或上网下载。 1)

The registration for 2014 Tuition Programme will be open for application from November 2013. Application forms are available at school, CDAC Centre or download from CDAC website.

2) 在 30-11-2013或之前把表格寄到华助会秘书处的合格申请者，将能在 2014 年 1 月开始上课。 2) Mail completed application forms to CDAC Secretariat Office by 30-11-

2013 for January 2014 admission. 豁免补习费豁免补习费豁免补习费豁免补习费 FEE WAIVER

1) 成功的助学金申请者在参加 2014 年华助会补习班时豁免学费。 1) Successful bursary applicants will enjoy tuition fee waiver when they participate in CDAC Tuition Programme in 2014.

2) 只限在 2014 年参加华助会补习班的学生。 2) Only for students participating in CDAC Tuition Programme 2014. ��活动费津贴活动费津贴活动费津贴活动费津贴 Activity Fee Subsidy

申请者须知申请者须知申请者须知申请者须知 Applicants to take note 关于华助会关于华助会关于华助会关于华助会活动费津贴活动费津贴活动费津贴活动费津贴 ABOUT CDAC ACTIVITY FEE SUBSIDY

1) 为低收入家庭的学生提供活动津贴的目的是帮助他们能负担得起参加华助会中心的活动费用，从而塑造品格和建立自信心；或是在课业、科学、美术、个人才华上发挥潜能，精益求精。 1) The fee subsidy scheme is to enable needy students to participate in programmes offered at CDAC Centres to develop their characters and enhance self-esteem; as well as to help promising ones to excel in their studies or in Science, Arts or individual talent. 华助会华助会华助会华助会中心和开放时间中心和开放时间中心和开放时间中心和开放时间 LOCATIONS AND OPERATING HOURS OF CDAC CENTRES

1) 华助中心设于各组屋区，以更好地为学生、工友和家庭提供服务。华助会希望能通过中心把活动和计划带到社区。华助会的活动和计划的表格都能在华助会中心索取及呈交。 1) The CDAC Centres are strategically located to better serve students, workers and families. Through the Centres, CDAC aims to provide its services and programmes to the community near to their homes. Application forms for the various CDAC programmes, activities and assistance schemes can be obtained at and/ or submitted to these CDAC Centres. 华助会中心华助会中心华助会中心华助会中心 CDAC Centre 地址地址地址地址 Address 电话号码电话号码电话号码电话号码 Tel no 武吉班让 Bukit Panjang Blk 270 Bangkit Road #01-22 S670270 6465 4411 裕廊 Jurong Blk 421 Jurong West Street 42 #01-1045 S640421 6569 3573 榜鹅 Punggol Blk 512 Hougang Avenue 10 #01-67 S530512 6387 5455 红山 Redhill Blk 83 Redhill Lane #01-85 S150083 6475 6567 盛港 Sengkang Blk 321-B Anchorvale Drive #01-196 S542321 6312 5329 淡滨尼 Tampines Blk 158 Tampines Street 12 #01-77 S521158 6783 4649 丹戎加东 Tanjong Katong 65 Tanjong Katong Rd, Blk B Level 1 S436957 6603 5577 大巴窑 Toa Payoh No. 381 Lorong 1 Toa Payoh (Beside Braddell MRT) Level 2, OnePeople.sg Building S319758 6258 8339 兀兰 Woodlands Blk 317 Woodlands Street 31 #01-194 S730317 6363 2120 油池 Yew Tee Blk 627 Choa Chu Kang Street 62 #01-160 S680627 6765 3302 义顺 Yishun Blk 145 Yishun Street 11 #01-41 S760145 6752 7760 开放时间 Opening hours ▪周一至五 Mon-Fri: 1pm – 10pm ▪周六及星期日 Sat & Sun: 10am – 5pm ▪公共假期休息 Closed on Public Holidays

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第一部分第一部分第一部分第一部分 PART I: 学生资料学生资料学生资料学生资料 STUDENT’S INFORMATION S/No:

(A) 学生个人资料学生个人资料学生个人资料学生个人资料 Student’s Particulars (请仔细填写所有的栏目。Please complete every column.) 英文姓名 Name (以居民证为准 As in Birth Cert/ NRIC) 出生证/居民证号码 Birth Cert / NRIC No. 出生地 Country of Birth 国籍 Citizenship

� 新加坡公民 Singapore Citizen

� 新加坡永久居民 Singapore Permanent Resident

性别 Gender

� 男 Male

� 女 Female

种族 Race

出生日期 Date of Birth 日 Date 月 Month 年 Year 目前就读学校 Name of current School 手机号码 Mobile No. (本身 Self) 电邮 Email Address

住家地址 Residential Address 邮区 Postal Code 您是否有在 2013 年有参加华助会补习班 Participated in CDAC Tuition Programme 2013? � 是 Yes � 否 No 若‘是’，请注明补习中心名称 If ‘Yes’, please indicate tuition centre _________________________和补习科目 and tuition subjects _______________________ 华助会中心会员华助会中心会员华助会中心会员华助会中心会员 CDAC Centre Membership 您的孩子是不是华助会中心会员？ Is your child a member of CDAC Centre?

� 是 Yes, 我的孩子是华助会@____________ （中心）的会员。 Yes, my child is a member of CDAC@ ________________ (centre name).

� 如否，您是否同意让孩子成为华助会中心会员，并接受华助会寄给您益智活动的宣传资料?

If no, are you agreeable to sign your child up for centre membership and receive publicity materials from CDAC on enrichment programmes?

� 是，请选择华助会中心（您可选择超过一所） Yes, please choose the CDAC Centre (you may choose more than one)

� 武吉班让 Bukit Panjang � 裕廊 Jurong � 榜鹅 Punggol � 红山 Redhill � 盛港 Sengkang

� 淡滨尼 Tampines � 丹戎加东 Tanjong Katong � 大巴窑 Toa Payoh � 兀兰 Woodlands � 油池 Yew Tee � 义顺 Yishun

� 否 No 只有申请助学金的学生必须填写以下部分只有申请助学金的学生必须填写以下部分只有申请助学金的学生必须填写以下部分只有申请助学金的学生必须填写以下部分，，，，并并并并请校方推荐请校方推荐请校方推荐请校方推荐

ONLY BURSARY APPLICANT NEEDS TO COMPLETE COLUMNS BELOW AND OBTAIN SCHOOL’S RECOMMENDATION

2014 年年年年就读年级就读年级就读年级就读年级////源流源流源流源流 Level / Stream in 2014 � 小学/特别学校 Primary/Junior Year __________

� 中学/特别学校 Secondary/Senior Year________ # Exp / NA / NT

� 直通车 Integrated Programme Year _________

� 高中/初级学院 Centralised Institute/Junior College Year ________

� 工艺教育学院 NITEC Year _______

� 工艺教育学院（高级）Higher NITEC Year _______ 请注明助学金的接收方式请注明助学金的接收方式请注明助学金的接收方式请注明助学金的接收方式 Please indicate your choice of receiving the Bursary

� 财路转账存入学生学生学生学生的邮政储蓄银行/星展银行户头。GIRO ---- Credit directly to Student’s POSB / DBS bank account. 学生的个人个人个人个人银行户头号码 Student’s own Bank Account Number # POSB / DBS _______________________________

� 支票 Cheque(将通过学校转交给学生或由家长亲自到秘书处领取) (Will be handed to student through the school or to be collected by parent at CDAC Secretariat) 您是否在 2013/20142013/20142013/20142013/2014 年年年年领取任何以下项目? 请打勾并附上相关的文件（如有）。 Are you in receipt of any of the following in the year 2013/2014? Please tick and attach relevant documents (if any).

(1) 助学金 Bursary � 是 Yes � 否 No

(2) 奖学金 Scholarship � 是 Yes � 否 No

(3) 海峡时报零用钱计划 The Straits Times School Pocket Money Fund � 是 Yes � 否 No

(4) 教育部的经济援助计划 MOE Financial Assistance Scheme (FAS) � 是 Yes � 否 No

(5) 学校的其他经济援助计划 Other Financial Assistance Scheme from School � 是 Yes � 否 No

(6) 政府购屋及教育辅助计划 HOPE / Small Families Improvement Scheme � 是 Yes � 否 No

(7) 领取 2013 年度华助会–宗乡总会助学金 Recipient of CDAC – SFCCA Bursary 2013 � 是 Yes � 否 No 若若若若 (1) (1) (1) (1) ---- ((((5555) ) ) ) 您您您您填写填写填写填写‘‘‘‘是是是是’’’’，，，，请提供以下资料请提供以下资料请提供以下资料请提供以下资料 If ‘Yes’ for (1) – (5), please provide the following details: 名称名称名称名称 Name / Type 领取日期领取日期领取日期领取日期 / / / / 期限期限期限期限 Date / Period awarded 获颁项目及数额获颁项目及数额获颁项目及数额获颁项目及数额 Items received and amount 1.

2.

3.

4.

5.

# Delete accordingly where appropriate 请删除

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ENDORSEMENT AND RECOMMENDATION BY SCHOOL / CHILDREN’S HOME

PART (A): To be duly completed by Parent / Guardian (Tick if applicable �)

Name of Student:

NRlC/ BC No.: Class in 2014:

Dear Principal My child has met the following eligibility criteria for CDAC-SFCCA Bursary. Your recommendation for my child to apply for the said bursary is sought, please. Thank you.

Family Household Income

� Monthly household income not exceeding $1,500 � Per capita income not exceeding $450

Academic Result Slip / Progress Report

� Yes, the latest result slip / progress report is attached � No, there is no school examination

Conduct

� Excellent � Very Good � Good � Fair � Poor

Attendance

� at least 90% (State reason if not meeting the minimum attendance requirement) _______________________________________

__________________________________________________________________________________________________________

Name & Signature of Parent / Guardian:

Date:

PART (B): To be duly completed by School / Children’s Home (Tick if applicable �)

Name of referral: #Dr/ Mr/ Mrs/ Ms/ Miss/ Mdm

Designation: Name of School / Children’s Home:

Telephone No.:

Fax No.: Email Address:

Dear CDAC-SFCCA Bursary Administrator

This is to certify that the above student has met the eligibility criteria for the CDAC-SFCCA Bursary. His/her application is strongly supported, please. Student is in receipt of the following: � MOE Financial Assistance Scheme (FAS) in Year __________

� Special Education School Financial Assistance Scheme (SPED-FAS) in Year __________ � CDC & CCC-ITE #Bursary / Scholarship in Year __________

� Others (Please specify Type of assistance / Amount / Year : _________________________________________________________)

__________________________________________

Signature / Date

________________________________________ School’s / Children Home’s Stamp

Reg No. 199202625K

华助会华助会华助会华助会----宗乡总宗乡总宗乡总宗乡总会助学金会助学金会助学金会助学金 2012012012014444

CDAC–SFCCA BURSARY 2014

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第二第二第二第二部分部分部分部分 PART II 申请申请申请申请学生学生学生学生的家庭资料的家庭资料的家庭资料的家庭资料 FAMILY’S INFORMATION

Section I: 家长家长家长家长////监护人的资料监护人的资料监护人的资料监护人的资料 INFORMATION ON PARENTS /GUARDIAN(S)

姓名（居民证上的英文姓名）Name (as in NRIC / FIN)

出生日期 / Date of Birth 年龄 / Age 居民证号码 NRIC / FIN No.

(#粉红 Pink / 蓝 Blue)

国籍 Nationality

(#公民Citizen / 永久居民PR / 其他Others)

出生地 Country of Birth

联络电话 Contact No. 住家 Home :

手机 Mobile:

电邮（如有） Email Address (if any)

职业和担任的职位 Occupation & Position Held:

薪金 Salary (未扣公积金 Before CPF)

$

其他收入 Other Income:

$

� 雇主/公司名称 Name of Employer/ Company (包括自雇者 including self-employed person) :

� 公司地址 Company Address: 电话 Telephone No.:

姓名（居民证上的英文姓名）Name (as in NRIC / FIN)

出生日期 / Date of Birth 年龄 / Age 居民证号码 NRIC / FIN No.

(#粉红 Pink / 蓝 Blue)

国籍 Nationality

(#公民Citizen / 永久居民PR / 其他Others)

出生地 Country of Birth

联络电话 Contact No. 住家 Home :

手机 Mobile:

电邮（如有） Email Address (if applicable)

职业和担任的职位 Occupation & Position Held:

薪金 Salary (未扣公积金 Before CPF)

$

其他收入 Other Income:

$

� 雇主/公司名称 Name of Employer/ Company (包括自雇者 including self-employed person) :

� 公司地址 Company Address: 电话 Telephone No.:

Section II: 其他同住家庭成员其他同住家庭成员其他同住家庭成员其他同住家庭成员（（（（无需填写申请者和父母无需填写申请者和父母无需填写申请者和父母无需填写申请者和父母））））的资料的资料的资料的资料。。。。请注明在籍学生会不会申请助学金请注明在籍学生会不会申请助学金请注明在籍学生会不会申请助学金请注明在籍学生会不会申请助学金。。。。 Information on other family members (to exclude applicant and parents) staying in the same household. Student to state whether he/she will apply for Bursary. 姓名 Name (as in NRIC / FIN) 居民证号码

NRIC / FIN No. 与学生的关系Relationship 职业与公司名号/就读学校

Occupation & Company / School 每月薪金 Monthly Income

会申请助学金?请� Applying for Bursary？Pls � 1. 2. 3. 4. 5. 6. 7. 8.

父亲父亲父亲父亲

Fath

er’s / 监护人监护人监护人监护人

Guard

ian’s

母亲母亲母亲母亲

Mother’s

/ 监护人监护人监护人监护人 Guard

ian’s

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Section III: 其他相关的家庭其他相关的家庭其他相关的家庭其他相关的家庭资资资资料料料料 Other Information (如适用请打勾 Tick if applicable �)

(A) 住屋类别住屋类别住屋类别住屋类别 Housing Type

组屋 HDB Flat: � 1 Rm � 2 Rm �3 Rm �4 Rm �5 Rm �E-Flat � 其他 Others (请注明 Please state: ______________) 非组屋 Non HDB Flat: � 私人公寓 Condominium � 有地住宅 Landed Property � 其他 Others (请注明 Please state: ____________________) (B) 住屋拥有权住屋拥有权住屋拥有权住屋拥有权 House Ownership

购买 Owned: � 已付清 Fully Paid � 每月贷款 Monthly Loan: 现金 Cash $ ____________ / 公积金 CPF $____________

租赁 Rented: 每月租金 Rental per month: $ _________ � 其他 Others (请注明 Please state: ___________________________________________) (C) 汽车汽车汽车汽车 Car: � 有Yes � 没有 No (拥车者请提供资料 Car owner please provide details)

车款 Car Model:________________ 购买年份 Year of Purchase: _______ 每月贷款 Monthly Loan:$ ______ 每月开销 Monthly Expenses:$______ 车牌号码 Vehicle No.: _____________ 拥车原因 Reason: __________________________________________________________________________________ (D) 女佣女佣女佣女佣 Maid: � 没有 No � 有 Yes 原因 Reason: _______________________________________________________________________________ (E) 其他的经济来源其他的经济来源其他的经济来源其他的经济来源 Other Sources of Income

如果您家庭每月有其他的经济来源如果您家庭每月有其他的经济来源如果您家庭每月有其他的经济来源如果您家庭每月有其他的经济来源，，，，请在适合的方格内打请在适合的方格内打请在适合的方格内打请在适合的方格内打勾勾勾勾并并并并写下写下写下写下每月每月每月每月获得的款项获得的款项获得的款项获得的款项。。。。 If your family has other sources of income(s), please tick the appropriate box(es) and indicate the amount that is received every month.

� 赡养费 Maintenance fee: $ ___________

� 租金收入 Rental income: $ ___________

� 公积金每月退休金 Monthly Payout from CPF Retirement Account: $____________

� 保险赔偿（例如:家属保障计划）Insurance compensation (e.g. Dependants’ Protection Scheme): $___________

� 其他 Others (请列下收入来源及每个月的款项。Please specify income source and amount received.): $___________

_________________________________________________________________________________________________________________ (F) 您的家庭目前是否有接受任何机构或人士的经济援助您的家庭目前是否有接受任何机构或人士的经济援助您的家庭目前是否有接受任何机构或人士的经济援助您的家庭目前是否有接受任何机构或人士的经济援助？？？？

Is your family receiving any financial assistance from other organisations or persons? � 有 Yes � 没有 No 如果如果如果如果‘‘‘‘有有有有’’’’，，，，请提供以下资料请提供以下资料请提供以下资料请提供以下资料并附上相关的文件并附上相关的文件并附上相关的文件并附上相关的文件。。。。If ‘yes’, please provide the following details and attach the relevant documents. 机构名称或人士姓名机构名称或人士姓名机构名称或人士姓名机构名称或人士姓名 Name of organisation / Person

电话号码电话号码电话号码电话号码 Telephone No.

经济援助种类及数额经济援助种类及数额经济援助种类及数额经济援助种类及数额 Type of assistance and Amount

期限期限期限期限 Period

1.

2.

3.

4.

5. (G) 您的家庭目前是否有拖欠任何费用您的家庭目前是否有拖欠任何费用您的家庭目前是否有拖欠任何费用您的家庭目前是否有拖欠任何费用？？？？如有如有如有如有，，，，请填请填请填请填写写写写以下栏目以下栏目以下栏目以下栏目。。。。

Does your family have any outstanding bills? If yes, please fill in the table below. 欠款欠款欠款欠款（（（（请附上以下所有欠款单据的复印本请附上以下所有欠款单据的复印本请附上以下所有欠款单据的复印本请附上以下所有欠款单据的复印本）））） Outstanding bills (please attach a copy of all the arrears indicated below)

各项总数各项总数各项总数各项总数 ($)($)($)($) TOTAL AMOUNT ($) 租金 / 房屋贷款

Rental / Housing Loan Instalment 水电费

Utilities 杂费

Service & Conservancy charges 电话费

Telephone charges 医药费

Medical fees 贷款

Loans 其他欠款（请注明）：

Other outstanding bills (please specify): 总数总数总数总数 Total($):

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Section IV: 家长家长家长家长////监护人和学生声明监护人和学生声明监护人和学生声明监护人和学生声明 Declaration by Parent/Guardian and Student 我谨此确认并作出以下声明： 1) 表格内所填写的资料及所附上的文件副本全部属实。如果我提供不实的资料，我会承担所应负的责任。 2) 授权华助会在必要时向相关机构或人士查证我所提供的资料。 3) 华助会把我和家人的资料输入社会及家庭发展部的电脑资料库是必要的，有关资料都将被保密，并只作为协调华助会与其他机构提供经济援助申请的用途；也只有获得授权的人士和机构能使用。但是，在涉及法律程序时，资料将会被提供给有关机构。 4) 我的孩子并没有在 2013/2014 年从以下的项目受惠：

- 任何奖、助学金（教育储蓄奖学金和优异助学金除外）和海峡时报零用钱基金 - 初级学院、高级中学、直通车（5 及 6 年级）教育部经济援助金 - CDC-CCC ITE 助学金/奖学金。

5) 我的家庭并没有从政府购屋及教育辅助计划(HOPE)受惠。

6) 我的孩子是在籍学生，并在学校品行良好及达到至少 90%的良好出席率。 7) 我了解华助会-宗乡总会助学金的目的是为我的孩子提供经济援助，以鼓励他们考取更好的学业成绩。 8) 我同意即使我的孩子符合申请资格，也不保证申请一定会获得批准。

9) 我同意华助会使用表格中的个人资料以电子和非电子通讯方式提供我及家人华助会的活动讯息。

I hereby declare and acknowledge the following:

1) the information provided in this application form and supporting documents are true. I undertake to refund the

value of benefits received by my child/ward if any of the information is found to be false.

2) the information provided by me in this application form, or any part thereof, may be provided to any

Government departments, statutory boards, or any other entity when necessary, and I consent to this being

done.

3) the entry of information of my family members into the MSF ComCare database is necessary and will be kept

confidential. It will only be shared with authorized persons or agencies for facilitating application for financial

assistance from CDAC and other organisations. However, if the information has any legal implications, it will be

disclosed to relevant authorities when necessary.

4) my child/ward is not in receipt of the following for year 2013/2014:

- other scholarship or bursary (except Edusave scholarship and Merit Bursary)

- The Straits Times School Pocket Money Fund

- JC / CI / Integrated Programme Year 5 & 6 MOE-FAS

- CDC-CCC ITE Bursary / Scholarship.

5) my family is not under Home Ownership Plus Education (HOPE) Scheme.

6) my child/ward is a current student of the school and he/she has good conduct and has attained at least 90%

attendance rate.

7) the CDAC-SFCCA Bursary will provide financial assistance for my child/ward to do better in his/her studies.

8) I agree to comply with all the terms and conditions of the Student Assistance & Support Scheme and

understand that my child/ward’s application may be rejected by CDAC even though he/she may be eligible for

the Scheme.

9) I allow CDAC to use the personal data in this application form to keep me and my family updated of any CDAC

activities through the use of electronic and non-electronic types of communication. 家长/监护人名字/签名 Name and signature of Parent/Guardian

: 申请日期

Application submission date :

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Section V: 声明声明声明声明 (如适用请填妥如适用请填妥如适用请填妥如适用请填妥) Declaration (complete where applicable)

(A) 自雇人士声明自雇人士声明自雇人士声明自雇人士声明 Declaration of Self-Employment 英文姓名 Name

居民证号码 NRIC No. 工作性质(如买卖生意，小贩，徳士司机等)

Nature of Self-Employment (eg retail business,

hawker, taxi driver, etc)

每月收入 Gross Monthly

Income

签名/日期Signature/Date

1.

2.

3.

4.

(B) 无法呈交薪金证件无法呈交薪金证件无法呈交薪金证件无法呈交薪金证件////兼职者声明兼职者声明兼职者声明兼职者声明 Declaration of Employment without income documents/Part-Time Employment 英文姓名 Name

居民证号码 NRIC No. 职业(如散工，请注明工作性质 )

Occupation (for odd job,

please describe job

nature

无法呈交原因Reason(s) for not

producing documents

每月收入 Gross Monthly

Income


1.

2.

3.

4.

(C) 失业者声明失业者声明失业者声明失业者声明 Declaration of Unemployment 英文姓名 Name

居民证号码 NRIC No. 从几时失业 Unemployment since (mth/yr)

失业原因(如：家庭主妇，辞职，被裁，退休，健康理由等)

Reason for unemployment (eg.

housewife, retrenched, resigned, retired

etc)


1. ____(月 mth) _____ (年 yr)

2. ____(月 mth) _____ (年 yr)

3. ____(月 mth) _____ (年 yr)

4. ____(月 mth) _____ (年 yr)

(D) 赡养费赡养费赡养费赡养费声明声明声明声明 Declaration of Maintenance Fee 英文姓名 Name

居民证号码 NRIC No. 从几时没有收到前配偶的赡养费 Have not receive maintenance fee from my ex-spouse since (mth/yr)

签名/日期 Signature/Date

1. ______(月 mth) _______ (年 yr)

2. ______(月 mth) _______ (年 yr)