private and confidential - coleman college · 2016-10-10 · 4. updated resume if applicant has...

Document : CC-EDT-C2.6.1 FM1 Effective Date: 1 August 2014 Revision: 5.0 Applicant’s Signature: __________________ Date: _________________ of 8

COLEMAN COLLEGE

RCB: 201000093K

COURSE APPLICATION FORM

科文学院

COLEMAN COLLEGE 167 Jalan Bukit Merah, Connection one, Tower 4 #02-15 Singapore 150167 Tel: (65) 6336 3462 Fax: (65) 6336 0929

Email: [email protected] | website: www.colemancollege.edu.sg

INSTRUCTIONS Thank you for Choosing Coleman College as your education partner. Please help us to process your application promptly by completing this form. Incomplete or inaccurate information could delay the processing of your application. Please print or write clearly in BLOCK letters. All applications should include the following documents:

1. Copy of Applicant’s Passport.

2. Three (3) passport size coloured photographs (with

white background).

3. Copies of Applicant’s birth certificate, latest

educational certificates and transcripts (Original

language and in English translation).

4. Updated resume if Applicant has working experience

for more than one (1) year.

5. All students are required to buy an insurance policy

under the EduTrust’s Fee Protection Scheme (FPS).

6. All students are required to purchase medical

insurance coverage under the EduTrust’s Certification

Scheme.

7. Students will receive the Letter of Offer and enter

into a Standard Student Contract upon admission.

RCB and UEN no: 201000093K CPE 4-Year Registration / Expiry: 24 June 2018

IMPORTANT NOTE ON PERSONAL DATA CONFIDENTIALITY POLICY The Information provided by you will be held and may be processed as data on a

computer system or maintain as printed copies for future references purposes. The College will take all reasonable precautions to ensure its confidentiality and to the

College’s Confidential Agreement and Security Policy.

Private and Confidential

mailto:[email protected]

http://www.colemancollege.edu.sg/


入学申请表 (APPLICATION FORM / MẪU ĐƠN XIN HỌC)

Note: Information you have provided will be kept confidential and used solely for course application purposes and for communicating with you. Chú ý: Mọi thông tin bạn cung cấp sẽ được giữ bí mật và chỉ sử dụng cho mục đích nộp đơn xin học và liên lạc với bạn 此申请表的每一个格子都必须填写不可有任何空缺.

(All the spaces in this form must be filled. Where not applicable, indicate with a “NA” (Not Applicable). Tất cả các ô trống nên được điền đẩy đủ. Không nên để trống bất cứ ô nào

报读课程 /COURSE APPLIED FOR/ KHOÁ HỌC:

申请者个人资料 / PERSONAL PARTICULARS / PHẦN THÔNG TIN CÁ NHÂN

中文姓名 Chinese Name Tên Tiếng Trung

英文姓名 English Name Tên Tiếng Anh

性别/Gender Giới tính

护照号码／有效日期 Passport No. / Issue Date / Expiry Date Số hộ chiếu/ Ngày hết hạn

出生日期年月日 Date of Birth (day/month/ year )

出生地点 Place of Birth / Nơi sinh

出生證書號碼 Birth Certificate No.

电子邮箱 Email Address

住址/Address / Địa chỉ 手机电话 MTelephone / Điện thoại

职业 Occupation / Nghề nghiệp

宗教信仰 Religion.

现有地址居住时间 Number of Years of Residence

（Please check appropriate box）

1 Year and below 2-4 Years > 4 years ( )

住宅电话/Telephone (Residential) / Điện thoại

传真/Fax

If Married, Details of Spouse/ 配偶资料 /Vợ/chồng 婚姻状况/Marital Status Tình trạng hôn nhân： Single / Married / Divorced (please check box)

中文姓名/Chinese Name /Tên tiếng Trung 英文姓名 English Name / Tên tiếng Anh

职业 Occupation / Nghề nghiệp

教育背景 (按時間順序填寫) / APPLICANT’S EDUCATIONAL BACKGROUND (IN CHRONOLOGICAL ORDER) QUÁ TRÌNH HỌC TẬP CỦA NGƯỜI NỘP ĐƠN (GHI THEO TRÌNH TỰ THỜI GIAN)

校名 Name of College / University Tên trường/ Đại học

国家 Country Quốc gia

区或省 State or Province

Tỉnh, Phường,Xã

教课语言

Language of Instruction

Ngôn ngữ học tập

求学期间(Duration of Study) 最高学历 Highest Educational Qualification

Bằng cấp cao nhất

Certificate Number

开始 (From) / Từ (dd/mm/yyyy)

离开 (To) /Đến (dd/mm/yyyy)

Direct application

Referred by agent

Transfer from other college

Others – please specify

_____________________________

照片 Photograph

Ảnh


校名 Name of College / University Tên trường/ Đại học

国家 Country Quốc gia

区或省

State or Province Tỉnh, Phường,Xã

教课语言

Language of Instruction

Ngôn ngữ học tập

求学期间(Duration of Study)

最高学历

Highest Educational Qualification Bằng cấp cao nhất

Certificate Number

Pass in English

申请者工作经历由最早到最近 / APPLICANT’S EMPLOYMENT HISTORY (IN CHRONOLOGICAL ORDER) / QUÁ TRÌNH LÀM VIỆC ( GHI THEO TRÌNH TỰ THỜI GIAN)

公司

Name of Company / Firm

Tên công ty/ Nhà máy

工作时期 (Working Period) 职业工作性质

开始日期 (Start) / Từ (dd/mm/yyyy)

离开日期 (End) / Đến (dd/mm/yyyy)

Position Held Vị trí công việc

Nature of Duties Chức năng, nhiệm vụ công việc

其它资料 (OTHER DETAILS - CHI TIẾT KHÁC)

申请者的配偶 (如适用) APPLICANT’S SPOUSE (IF APPLICABLE) - VỢ/CHỒNG CỦA NGƯỜI NỘP ĐƠN (NÊU CÓ) 英文姓名 Name Tên Tiếng Anh

关系Relationship

Quan hệ

出生日期 Date of Birth

Ngày sinh

出生地点 Place of Birth

Nơi sinh

国籍Nationality Quốc tịch

身份证号码Identity No. Số CMTND

新加坡的记录 Residential Status in Singapore

Tình trạng cư trú tại Singapore (Tick)

职业 Occupation

Nghề nghiệp

新加坡公民/永久居民份证号码

S’pore citizen/ S’pore Permanent Resident NRIC No.

Công dân Singapore/ Đăng ký thường trú tại Singapore Số:

居留签证／工作准证号码

Resident (Long term/work/dependent pass) FIN NO.

Định cư ( có giấy phếp lao động/làm việc lâu dài) SỐ:

以上皆非 None of the above

Không thuộc các trường hợp trên

(If insufficient space, please use a separate sheet of paper. 若此表格不够填写空间请用另一纸张填寫 Nếu không viết đủ hãy viết vào tờ giấy riêng biệt khá


申请者生父生母或继父继母 (APPLICANT’S NATURAL PARENTS AND /OR STEP PARENTS) / CHA ME RUOT / HOAC CHA ME NUOI CUA NGUOI NOP DON 英文姓名 Name Tên Tiếng Anh

关系Relationship

Quan hệ

出生日期 Date of Birth

Ngày sinh

出生地点 Place of Birth

Nơi sinh

国籍 Nationality Quốc tịch

身份证号码 Identity No. Số CMTND

新加坡的记录 Residential Status in Singapore

Tình trạng cư trú tại Singapore (Tick)

职业 Occupation

Nghề nghiệp

新加坡公民/永久居民份证号码

S’pore citizen/ S’pore Permanent Resident NRIC No. Công dân Singapore/ Đăng ký thường trú tại Singapore Số:

居留签证／工作准证号码 Resident (Long term/work/dependent pass) FIN NO.



Không thuộc các trường hợp trên 新加坡公民/永久居民份证号码

S’pore citizen/ S’pore Permanent Resident NRIC No.


居留签证／工作准证号码

Resident (Long term/work/dependent pass) FIN NO. Định cư ( có giấy phếp lao động/làm việc lâu dài) SỐ:


Không thuộc các trường hợp trên 新加坡公民/永久居民份证号码

S’pore citizen/ S’pore Permanent Resident NRIC No. Công dân Singapore/ Đăng ký thường trú tại Singapore Số:

居留签证／工作准证号码 Resident (Long term/work/dependent pass) FIN NO. Định cư ( có giấy phếp lao động/làm việc lâu dài) SỐ:

以上皆非 None of the above Không thuộc các trường hợp trên

申请者的兄妹資料(APPLICANT’S SIBLING - ANH CHỊ EM NGƯỜI NỘP ĐƠN)

姓名

Name Tên Tiếng Anh

关系

Relationship Quan hệ

出生日期

Date of Birth Ngày sinh

出生地点

Place of Birth Nơi sinh

国籍

Nationality Quốc tịch

身份证号码

Identity No. Số CMTND

新加坡居留记录

Residential Status in Singapore Tình trạng cư trú tại Singapore (Tick)

职业

Occupation Nghề nghiệp

新加坡公民/永久居民份证号码 S’pore citizen/ S’pore Permanent Resident NRIC No. Công dân Singapore/ Đăng ký thường trú tại Singapore Số:



以上皆非 None of the above Không thuộc các trường hợp trên

新加坡公民/永久居民份证号码 S’pore citizen/ S’pore Permanent Resident NRIC No.







姓名

Name Tên Tiếng Anh

关系

Relationship Quan hệ

出生日期

Date of Birth Ngày sinh

出生地点

Place of Birth Nơi sinh

国籍

Nationality Quốc tịch

身份证号码

Identity No. Số CMTND

新加坡居留记录

Residential Status in Singapore Tình trạng cư trú tại Singapore (Tick)

职业

Occupation Nghề nghiệp

新加坡公民/永久居民份证号码 S’pore citizen/ S’pore Permanent Resident NRIC No.






申請者財務情况說明(APPLICANT’S FINANCIAL SUPPORT – IF AN ENTRY VISA TO SINGAPORE IS REQUIRED) CUNG CẤP TÀI CHÍNH CHO NGƯỜI NỘP ĐƠN - ĐỐI VỚI NHỮNG NƯỚC YÊU CẦU VISA VÀO SINGAPORE

申请者

(APPLICANT) NGƯỜI NỘP ĐƠN

过去 6 个月的平均薪水

Average monthly income for past 6mths Thu nhập bình quân trong 6 tháng gần nhất

配偶 (SPOUSE) VỢ/CHỒNG



银行存款 (例如定期存款)

Current Saving (eg. Fixed Deposit) Tiết kiệm hiện tại:(ví dụ: Đặt cọc cố định)

银行存款例如定期存款


父亲

(FATHER)

CHA/BỐ



母亲

(MOTHER) MẸ



银行存款 (例如定期存款)


银行存款例如定期存款


其他亲属的经济或財務状况 Other financial support from immediate family members Hỗ trợ tài chính khác trực tiếp từ thành viên trong gia đình

有 / Yes / Có 没有 / No / Không

(如有，请将资料填写在另一张纸 If ‘Yes’, please provide details on a separate sheet)

Nếu có hãy ghi chi tiết ra tờ giấy riêng biệt

Nếu không viết đủ hãy viết vào tờ giấy riêng biệt khá (If insufficient space, please use a separate sheet of paper | 若此表格不够填写空间,请写在另一张纸)


其他个人历史 (ANTECEDENT - TIỀN SỬ ) (Please Tick)

1. Have you ever been refused entry into or deported from any country? Bạn đã từng bị tự chối nhập cảnh hay bị trục xuất khỏi bất cứ quốc gia nào chưa?

你曾经被拒绝进入任何国家吗或被驱逐处境过吗

2. Have you ever been convicted in a court of law in any country? Bạn đã từng bị buộc tội tại toà án nào ở bất kỳ quốc gia nào không?你有在他國被判過罪刑嗎？

3. Have you ever been prohibited from entering Singapore? Bạn đã từng bị cấm vào Singapore? 你曾经被禁止进入新加坡吗?

4. Have you ever entered Singapore using a different Passport or Name? Bạn đã từng vào Singapore với tên và hộ chiếu khác không? 你曾经使用过其他护照证件进入过

新加坡吗

如果以上回答是是请在另外一张纸上说明详细情况.

If any of the answers is ‘YES’, please furnish details on a separate sheet of paper / Nếu trả lời có hãy cung cấp chi tiết và ghi ra tờ giấy riêng biệt

有 Yes/ Có

有 Yes/ Có

有 Yes/ Có

有 Yes/ Có

没有/No /Không

没有/No /Không

没有/No /Không

没有/No /Không

入学须知 / NOTES TO THE APPLICANT / GHI CHÚ DÀNH CHO NGƯỜI NỘP ĐƠN Students have to abide by the rules and regulations set by the College. / Sinh viên phải chấp hành theo quy định và nội quy của Trường

1. Before the students register, they should know the period of course, the course outline and the fees. 学员在报名前应了解课程学习时间表，所学课程和有关的费用等。Trước khi sinh viên đăng ký, họ nên biết về quá trình học, điểm chính của khoá học và học phí

2. Students are supposed to concentrate on their studies, hand up their work on time and obtain good grades.

学员应以学业为重，按时完成作业，争取好成绩。 Sinh viên cần phải tậpt rung vào việc học tập, nộp bài đúng hạn và đạt điểm tốt

3. Students have to be punctual for lessons and obtain at least 90% attendance. 学员上课不许迟到或早退，出席率必须维持在％以上。

Sinh viên phải đến lớp đúng giờ và đạt được ít nhất 90% số tiết

4. Foreign students with student pass are not allowed to work. 学员在新加坡学习期间不许打工。Sinh viên quốc tế có thẻ sinh viên không được phép đi làm 5. Upon completion of the course and without valid reason and approval from the relevant authorities, students must return to their country at the specified time. Students must surrender their

Student’s Pass to the Singapore Immigration within 7 days of cessation of course. 修读期满后，如无其他合法的理由和政府的批准，学生必须在限期内返回原籍地，在学生准证到期七天内

停止就读，并通知移民厅局离开的日期和方式，违反者将罚款和遣送回国。 Khi đã hoàn thành khoá học, nếu không có lý do chính đáng và sự đồng ý từ các nhà chức trách có liên quan, sinh viên phải quay về nước theo đúng thời gian đã định. Sinh viên phải nộp lại Thẻ Sinh viên và Thẻ Embarkation cho Sở di trú Singapore trong vòng 7 ngày kể từ khi chấm dứt thời hạn. Sinh viên vi phạm quy định và luật pháp Singapore sẽ bị tịch thu sung công khoản phí đặt cọc an ninh hoặc bị tuyên cáo.

6. During your stay in Singapore, you agree to abide by the local laws and regulations. The College will not be held responsible if the student’s students pass application is not renewed or if the student is deported by Immigration. 学员在新加坡学习期间必须遵守移民厅条款和新加坡政府的法律及规定。如学员申请不到继续留新的学生准证延期而被遣送回国，学校将不对此责。若学生违犯法律，学生需自负责任，学校概不负责。

Trong suốt quá trình sinh viên ở tại Singapore, họ phải tuân thủ đúng luật lệ và quy định. Người bảo lãnh bảo lưu quyền từ chối bảo lãnh. Trường Cao đẳng sẽ không bị chịu trách nhiệm nếu thẻ sinh viên của họ không được cấp mới hoặc họ bị trục xuất

7. Student’s particulars obtained are solely for the purpose of completing course submission. Coleman College will ensure that all student’s information is kept confidential at all times and shall

seek consent from student should his/her particulars be used for purposes other than billing or marketing. FEE PROTECTION SCHEME (FPS) The Fees Protection Scheme is available in 2 forms, either insurance or escrow scheme. Under the CPE regulations, this scheme is compulsory for all students. Coleman has appointed Lonpac Insurance Bhd as our FPS insurance provider. Under the FPS insurance scheme, students’ fees are insured by Lonpac Insurance Bhd. In the case of events, as stated in the terms of the insurance coverage, students protected under this scheme will be able to make a claim from Lonpac for the fees they paid.

MEDICAL INSURANCE COVERAGE

ALL full-time students are covered with Medical Insurance – Group Hospital & Surgical Insurance and Group Personal Accident Insurance with HSBC Insurance under the Student Enrich Scheme provided by Liberty Insurance Pte. Ltd. The benefits include:

1. Annual limit of S$20,000.00 2. B2 Ward in government and restructured hospitals up to the overall maximum limit per policy period. 3. 24 hours coverage in Singapore and overseas (if student is involved in college-related activities) throughout course duration.

*Students can refer to the “Product Summary –Liberty Insurance Pte. Ltd.” handout stating clearly the policy’s terms and conditions, the claim procedure, any exclusion etc.

Note: The following Terms and Conditions apply to all students of Coleman College in Singapore. All fees and monies when mentioned are in Singapore currency. Once signed, these terms and conditions are legally binding under the laws and jurisdiction of the Republic of Singapore.


TERMS AND CONDITIONS

1. Admission Policy Admission to Coleman College (henceforth known as the College) is opened to all individuals regardless of gender, race, religion or nationality. Selection for admission is based on an

overall assessment of the individual’s academic merit and meeting all other required course entry requirements where applicable. Students with approved admission will be provided with Letter of Offer from the College. The College reserves the rights to reject an application and to review a student’s progress periodically. The College may, at its discretion, cancel a student’s registration for lack of academic progress, failure to honour fees payable or failure to abide by the Rules and Regulations outlined in the Student Handbook.

Important Notes: a. All prospective students (both local and international) will enter into a Standard Student Contract with Coleman College upon receipt of the In-Principle Approval of a Student’s

Pass from the ICA. b. The exact amount of tuition fees and non-tuition fees, the payment terms, the refund/transfer/withdrawal policies pertaining to the course are as specified in the Letter of Offer. c. Students should be aware that all relevant documents/certificates/diplomas/degrees submitted are non-returnable. Acceptance of your application form does not constitute an

offer of admission into Coleman College; you also have to satisfy the academic qualification requirements for the applied course. You are required to furnish Coleman College with all the necessary documents as needed for the applied course.

d. All students' particulars obtained are solely for the purpose of completing course application and administrative processes. Coleman College will ensure that your information is kept confidential at all times and will seek consent from you should your particulars be used for other purposes.

e. We undertake to use best efforts to assist the student if he/she requires a Student's Pass from the ICA. The Student's Pass issued is non-transferable and will expire upon the student ceasing to be our student.

f. Students must maintain good conduct at all times and must observe the conditions under which the Student Pass is granted by ICA and the law of the Republic of Singapore. Any student found to be in violation of any rules, regulations or laws will be subject to appropriate disciplinary action by the relevant authorities.

2. Transfer and Withdrawal Policy

Transfer of Program a. All requests for transfer to another program offered by the college must be accompanied by a duly completed “Program Transfer Form”. You will have deemed to decide to

terminate from your existing course of study. b. A non-refundable and non-transferable application fee is applied for applying to study in a new course (as indicated in the Form). c. Approval of transfer to a new course of study will be considered on a case-by-case basis subject to the student meeting the required admissions and program entry

requirements and approval from the college/external education partner where appropriate. d. For students who are aged 18 years and below, parental/guardian approval is required prior to request for transfer. e. For students who are under Company’s sponsorship, a written request must be made by the “Human Resource Department”. f. The college will process the transfer request no longer than 4 working weeks subject to the approval from ICA, the External Education Partner and parent/guardian, where

applicable.

Course Withdrawal a. All requests on withdrawals and refunds are to be accompanied by a duly completed “Student Withdrawal Form” and *parental/guardian approval where applicable. The

college will process the request and refund to the student within 7 working days according to the Refund Policy applicable to the course. The completed Student Withdrawal Form shall be submitted to Student Services Department.

b. *For students under 18 years of age, the college will seek parental/guardian approval prior to processing the request for withdrawal. c. For new commencing students, a grace period of 7 working days will be given upon signing of the Student Contract. A student is able to withdraw from the course with a

submission of a written notice within these 7 working days, notwithstanding if the course commencement date has passed. The student will be entitled to the maximum refund amount as stipulated by the college.


DECLARATION BY APPPLICANT | 申明

本人清楚以上条例，自愿申请报名参加修读有关课程，并遵守学院的一切规章制度。

I HAVE READ AND UNDERSTOOD THE ABOVE TERMS AND CONDITIONS. TÔI ĐÃ ĐỌC VÀ ĐÃ HIỂU TẤT CẢ CÁC NỘI DUNG VÀ ĐIỂU KIỆN TRÊN

1. I confirm that all the information stated in this Application Form is true, complete and correct. I understand that my application shall be withdrawn by Coleman

College if the information herein provided proves to be false. 2. I authorise the College to conduct any inquiry / investigation into the above information for authentication purposes. 3. I have been advised by the College and/or its agent on the following which is available on the college website: http://www.colemancollege.edu.sg

College fees and charges;

Refund policies. 4. I am fully aware that while I am a student of the College I shall abide by all the statutes, by-laws, regulations of the College and other regulatory bodies. 5. I confirm that I have received all information on:

Fees Protection Scheme

Letter of Offer

Service Commitment & College Polices Statements

Medical Insurance (Per calendar year)

Course Entry Requirements

Name and Signature of Applicant

Name and Signature of Parent / Guardian (For Applicant under the age of 18 Only)

Date

Date

OFFICIAL USE ONLY:

APPLICATION RECEIVED BY

DOCUMENTATION VERIFIED BY

APPLICATION APPROVED BY REGISTRAR

LETTER OF OFFER PREPARED AND ISSUED BY

DATE OF LETTER OF OFFER ACCEPTED BY STUDENT

CONFIRMATION THAT IPA, CONTRACT, FPS HAVE BEEN COMPLETED.

P-FILE UPDATED.

Name:

Name:

Name:

Name:

Name:

Name:

Signature/Date:

Signature/Date:

Signature/Date:

Signature/Date:

Signature/Date:

Signature/Date:

http://www.colemancollege.edu.sg/

private and confidential - coleman college · 2016-10-10 · 4. updated resume if applicant has...

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