Page 1 of 18 -- GLEEF Scholarship Application Form 2019 1 Cathedral of the Sacred Heart of Jesus Goh Lam Eng Educational Fund Year 2019 GLEEF Scholarship GLEEF-Scholarship Eligibility and Selection Criteria GOH LUM ENG EDUCATIONAL FUND OF THE CATHEDRAL OF THE SACRED HEART OF JESUS, Johor Bahru (GLEEF) was established in 2007 by the estate of the late Goh Lum Eng to support students who are under- privileged, poor or needy. The GLEEF is pleased to award scholarships each year to students in higher Educational Institutions. . Open for Application until 31 st March 2019 Application forms are available at the ‘Parish Office of the Cathedral of the Sacred Heart of Jesus, Jalan Keris, Taman Sri Tebrau, 80050 Johor Bahru, Johor, Malaysia’ or ‘Email:[email protected]’. Number of awards: Maximum of 4 (Four) most deserving candidates. Award payable: over the duration of the course. Date of Award: 28th April 2019
Transcript
Page 1 of 18 -- GLEEF Scholarship Application Form 2019 1
Cathedral of the Sacred Heart of Jesus
Goh Lam Eng Educational Fund
Year 2019 GLEEF Scholarship
GLEEF-Scholarship Eligibility and Selection Criteria
GOH LUM ENG EDUCATIONAL FUND OF THE CATHEDRAL OF THE
SACRED HEART OF JESUS Johor Bahru (GLEEF) was established in 2007
by the estate of the late Goh Lum Eng to support students who are under-
privileged poor or needy
The GLEEF is pleased to award scholarships each year to students in higher
Educational Institutions
Open for Application until 31st March 2019
Application forms are available at the lsquoParish Office of the Cathedral of the
Sacred Heart of Jesus Jalan Keris Taman Sri Tebrau 80050 Johor Bahru
Johor Malaysiarsquo or lsquoEmailofficeshcjborgrsquo
Number of awards Maximum of 4 (Four) most deserving candidates
Award payable over the duration of the course
Date of Award 28th April 2019
Page 2 of 18 -- GLEEF Scholarship Application Form 2019 2
Conditions For Application for Year 2019
1 The applicant must be from
under-privileged poor or needy family
2 The applicant must be enrolled in an approved educational institution
approved by the Board of Management
3 The applicant may be a full-timepart-time student as defined by the
institution in which heshe is enrolled
4 Scholarships will be awarded based on the merit(s) of the information
provided in the application form as determined by the Board of
Management giving consideration to academic performance financial
need leadership qualities and other factors outlined in the application
form
5 The Applicant must be a resident of Johor Catholic or Catechumen
6 Two (2) referees excluding relative one of whom must be the
Parish Priest
7 Only successful will be notified
8 The decision of the Board of Management is final and conclusive in all
proceedings
Page 3 of 18 -- GLEEF Scholarship Application Form 2019 3
Cathedral of the Sacred Heart of Jesus
Goh Lum Eng Educational Fund (GLEEF)
GLEEF Scholarship Application Form 2019
Please read the application procedures the terms and conditions stated in the second (next) page carefully
before completing the application form
Name
Recent Photograph
NRIC No
Ref
Page 4 of 18 -- GLEEF Scholarship Application Form 2019 4
Sila baca dengan teliti peraturan permohonan dan syarat-syarat yang dinyatakan di mukasurat kedua (2) sebelum mengisi borang permohonan
Application Procedures
1 Please print clearly or write legibly 2 All required documents must be submitted with the application
3 The Closing Date is as advertised Applications received after the closing date will be disqualified
4 False particulars or wilful suppression of material facts will render you liable to disqualification
5 Every section must be duly completed or indicate as rsquonarsquo if not applicable will also render you liable to disqualification
Note Proof of posting is not proof of receipt We will acknowledge receipt of your application by post or email
Peraturan Permohonan
1 Sila cetak atau tulis dengan jelas
2 Semua dokumen yang diperlukan hendaklah dilampirkan dengan borang permohonan
3 Tarikh tutup permohonan adalah seperti yang telah diiklankan Permohonan yang diterima selepas tarikh tutup permohonan akan ditolak
4 Maklumat yang palsu atau tidak lengkap atau fakta yang sengaja tidak dimaklumkan akan menyebabkan permohonan anda hilang kelayakan
5 Semua bahagian hendaklah diisi dengan penuh atau nyatakan ldquonardquo sekiranya tidak berkenaan Jika tidak permohonan anda juga akan
kehilangan kelayakan
Nota Bukti pengiriman tidak akan dianggap sebagai bukti penerimaan Kami akan memaklumkan penerimaan permohonan anda melalui pos ataupun
e-mail Please forward the completed Application Form and required documents to
Sila hantar Borang Permohonan yang lengkap bersama dokumen yang
diperlukan kepada
The Board of Management of GLEEF Cathedral of the Sacred Heart of Jesus
Jalan Kris Taman Sri Tebrau 80050 Johor Bahru
Johor
Page 5 of 18 -- GLEEF Scholarship Application Form 2019 5
MALAYSIA
Tel 07-3326831 Fax 07-3315511
Page 6 of 18 -- GLEEF Scholarship Application Form 2019 6
Section A Personal Details (PLEASE FILL IN BLOCK LETTERS)
bull Name
bull New IC No
bull Date of Birth
bull Gender Male Female
bull Race
bull Nationality
bull Marital Status Single Married Separated Divorced
bull Correspondence Address
Telephone(Home) Mobile
E-mail Fax
bull Permanent Home Address (if different from correspondence address)
Language Skills Level
Languages
Spoken Written
Page 7 of 18 -- GLEEF Scholarship Application Form 2019 7
Section B Educational Qualifications
Year
Obtained
Qualifications Grades
Page 8 of 18 -- GLEEF Scholarship Application Form 2019 8
Section C Work Experience (if any)
Name and Address of Employer Designation Period
Section D Extra- Curricular Activities
Details of extra-curricular activities including membership of societies associations (You may use a separate sheet of paper)
Section E Medical Condition
State present health condition and give details of any illness that requires attention
Page 9 of 18 -- GLEEF Scholarship Application Form 2019 9
Section F Personal Statement Supporting Your Application
I need this scholarshiphellip
Page 10 of 18 -- GLEEF Scholarship Application Form 2019 10
Section G Family Details
Father
Name
IC No
Home Address
Family Owned Rented
Tel Mobile
Name and address of employer
Tel
Occupation
Mother
Name
IC No
Home Address
Family Owned Rented
Tel Mobile
Name and address of employer
Tel
Occupation
Page 11 of 18 -- GLEEF Scholarship Application Form 2019 11
Guardian (If applicable)
Name
IC No
Home Address
Tel Mobile
Name and address of employer
Tel
Occupation
If parentsguardian are self- employed please provide the following particulars
bull Name and Address of Business
bull Nature of Business
bull Tel
bull Is the business wholly-owned
bull If partnership or joint venture state share held by parents guardian
bull Length of Establishment of Business ___ year(s) ___ month (s)
Page 12 of 18 -- GLEEF Scholarship Application Form 2019 12
Annual Gross Income of parents Guardian (Last year)
Father (RM)
Mother (RM)
Guardian (RM)
Employment
Business
Rental
Others
Total
Family Expenditure
Type of Expenditure Monthly Yearly
House InstalmentsRental
ElectricityWater
Telephone
Loan Repayment (carmotor-bikeappliance)
Transport
Education
Others
Total
Particulars of SiblingsOther Dependents
Name Relationship Age Marital
status
Occupation Annual
income
Page 13 of 18 -- GLEEF Scholarship Application Form 2019 13
Section H Details of your course
Which institution of higher learning has accepted you and attach your schedule
of fees and detailsDuration of your course
What are the sources of finances for your course (If sponsored please give relevant details)
a) Scholarship RM ___________ (Name __________________________________ )
b) Other sponsor RM ___________ (Name __________________________________ )
c) Fund or other source of monetary RM ___________
(Name __________________________________ )
Page 14 of 18 -- GLEEF Scholarship Application Form 2019 14
ADDITIONAL INFORMATION
Total Fee
Year 1 RM ___________
Year 2 RM ___________
Year 3 RM ___________
Year 4 RM ___________
Year 5 RM ___________
Food
RM __________ per month
Accommodation
RM __________ per month
Other expenses (please indicate)
RM __________ per month
PLEASE ATTACH A COPY OF THE FOLLOWING DOCUMENTS (SILA LAMPIRKAN SATU SALINAN DOKUMEN-DOKUMEN BERIKUT)
1048576 Letter of Acceptance of the institution (Surat Penerimaan dari Institusi)
1048576 A letter of Recommendation from a PriestBrotherSisterPerson of standing
eg Office Bearer of CMPPCPOHDPFCSt Vincent De Paul (Surat Sokongan
dari PaderiReligius (Brother atau Sister) Orang berkedudukan Greja Pemegang Jawatan
PPCPOHDFCSt Vincent De Paul)
1048576 Other supporting documents (if any) (Dokumen sokongan lain (jika ada))
Page 15 of 18 -- GLEEF Scholarship Application Form 2019 15
DECLARATON BY APPLICANT
Page 16 of 18 -- GLEEF Scholarship Application Form 2019 16
I understand that the Cathedral of the Sacred Heart GOH LUM ENG Educational Fund Board of Managementrsquos decision will be based on the information that I have provided and
Insufficient or Incomplete information given will render the application to be Rejected or Disqualified (Saya faham bahawa keputusan Lembaga Pengurusan Tabung Pendidikan Katedral Sacred Heart GOH LUM ENG adalah berdasarkan maklumat yang saya berikan Maklumat yang Tidak Cukup atau Tidak Lengkap akan menyebabkan permohonan saya ditolak atau dibatalkan)
I realise that giving false information will result in the scholarship being withdrawn and I will have to re-pay the tuition fees
(Saya sedar bahawa memberi maklumat palsu akan menyebabkan biasiswa ditarik balik dan saya dikehendaki untuk membayar balik segala yuran pengajian)
I am bonded not bonded to (any) organisation or receiving (any) financial aid from
(any) organisation (if yes please state the organisation name and the amount you have received) (Saya terikat tidak terikat kepada (mana-mana) organisasi atau menerima (mana-mana) bantuan kewangan dari (mana-mana) organisasi (jika ya sila nyatakan nama organisasi dan jumlah yang anda terima))
Name of the Organisation _________________________________________________________
1048576 Letter of Acceptance of the institution (Surat Penerimaan dari Institusi)
1048576 A letter of Recommendation from a PriestBrotherSisterPerson of standing
eg Office Bearer of CMPPCPOHDPFCSt Vincent De Paul (Surat Sokongan
dari PaderiReligius (Brother atau Sister) Orang berkedudukan Greja Pemegang Jawatan
PPCPOHDFCSt Vincent De Paul)
1048576 Other supporting documents (if any) (Dokumen sokongan lain (jika ada))
Page 15 of 18 -- GLEEF Scholarship Application Form 2019 15
DECLARATON BY APPLICANT
Page 16 of 18 -- GLEEF Scholarship Application Form 2019 16
I understand that the Cathedral of the Sacred Heart GOH LUM ENG Educational Fund Board of Managementrsquos decision will be based on the information that I have provided and
Insufficient or Incomplete information given will render the application to be Rejected or Disqualified (Saya faham bahawa keputusan Lembaga Pengurusan Tabung Pendidikan Katedral Sacred Heart GOH LUM ENG adalah berdasarkan maklumat yang saya berikan Maklumat yang Tidak Cukup atau Tidak Lengkap akan menyebabkan permohonan saya ditolak atau dibatalkan)
I realise that giving false information will result in the scholarship being withdrawn and I will have to re-pay the tuition fees
(Saya sedar bahawa memberi maklumat palsu akan menyebabkan biasiswa ditarik balik dan saya dikehendaki untuk membayar balik segala yuran pengajian)
I am bonded not bonded to (any) organisation or receiving (any) financial aid from
(any) organisation (if yes please state the organisation name and the amount you have received) (Saya terikat tidak terikat kepada (mana-mana) organisasi atau menerima (mana-mana) bantuan kewangan dari (mana-mana) organisasi (jika ya sila nyatakan nama organisasi dan jumlah yang anda terima))
Name of the Organisation _________________________________________________________
1048576 Letter of Acceptance of the institution (Surat Penerimaan dari Institusi)
1048576 A letter of Recommendation from a PriestBrotherSisterPerson of standing
eg Office Bearer of CMPPCPOHDPFCSt Vincent De Paul (Surat Sokongan
dari PaderiReligius (Brother atau Sister) Orang berkedudukan Greja Pemegang Jawatan
PPCPOHDFCSt Vincent De Paul)
1048576 Other supporting documents (if any) (Dokumen sokongan lain (jika ada))
Page 15 of 18 -- GLEEF Scholarship Application Form 2019 15
DECLARATON BY APPLICANT
Page 16 of 18 -- GLEEF Scholarship Application Form 2019 16
I understand that the Cathedral of the Sacred Heart GOH LUM ENG Educational Fund Board of Managementrsquos decision will be based on the information that I have provided and
Insufficient or Incomplete information given will render the application to be Rejected or Disqualified (Saya faham bahawa keputusan Lembaga Pengurusan Tabung Pendidikan Katedral Sacred Heart GOH LUM ENG adalah berdasarkan maklumat yang saya berikan Maklumat yang Tidak Cukup atau Tidak Lengkap akan menyebabkan permohonan saya ditolak atau dibatalkan)
I realise that giving false information will result in the scholarship being withdrawn and I will have to re-pay the tuition fees
(Saya sedar bahawa memberi maklumat palsu akan menyebabkan biasiswa ditarik balik dan saya dikehendaki untuk membayar balik segala yuran pengajian)
I am bonded not bonded to (any) organisation or receiving (any) financial aid from
(any) organisation (if yes please state the organisation name and the amount you have received) (Saya terikat tidak terikat kepada (mana-mana) organisasi atau menerima (mana-mana) bantuan kewangan dari (mana-mana) organisasi (jika ya sila nyatakan nama organisasi dan jumlah yang anda terima))
Name of the Organisation _________________________________________________________
1048576 Letter of Acceptance of the institution (Surat Penerimaan dari Institusi)
1048576 A letter of Recommendation from a PriestBrotherSisterPerson of standing
eg Office Bearer of CMPPCPOHDPFCSt Vincent De Paul (Surat Sokongan
dari PaderiReligius (Brother atau Sister) Orang berkedudukan Greja Pemegang Jawatan
PPCPOHDFCSt Vincent De Paul)
1048576 Other supporting documents (if any) (Dokumen sokongan lain (jika ada))
Page 15 of 18 -- GLEEF Scholarship Application Form 2019 15
DECLARATON BY APPLICANT
Page 16 of 18 -- GLEEF Scholarship Application Form 2019 16
I understand that the Cathedral of the Sacred Heart GOH LUM ENG Educational Fund Board of Managementrsquos decision will be based on the information that I have provided and
Insufficient or Incomplete information given will render the application to be Rejected or Disqualified (Saya faham bahawa keputusan Lembaga Pengurusan Tabung Pendidikan Katedral Sacred Heart GOH LUM ENG adalah berdasarkan maklumat yang saya berikan Maklumat yang Tidak Cukup atau Tidak Lengkap akan menyebabkan permohonan saya ditolak atau dibatalkan)
I realise that giving false information will result in the scholarship being withdrawn and I will have to re-pay the tuition fees
(Saya sedar bahawa memberi maklumat palsu akan menyebabkan biasiswa ditarik balik dan saya dikehendaki untuk membayar balik segala yuran pengajian)
I am bonded not bonded to (any) organisation or receiving (any) financial aid from
(any) organisation (if yes please state the organisation name and the amount you have received) (Saya terikat tidak terikat kepada (mana-mana) organisasi atau menerima (mana-mana) bantuan kewangan dari (mana-mana) organisasi (jika ya sila nyatakan nama organisasi dan jumlah yang anda terima))
Name of the Organisation _________________________________________________________
1048576 Letter of Acceptance of the institution (Surat Penerimaan dari Institusi)
1048576 A letter of Recommendation from a PriestBrotherSisterPerson of standing
eg Office Bearer of CMPPCPOHDPFCSt Vincent De Paul (Surat Sokongan
dari PaderiReligius (Brother atau Sister) Orang berkedudukan Greja Pemegang Jawatan
PPCPOHDFCSt Vincent De Paul)
1048576 Other supporting documents (if any) (Dokumen sokongan lain (jika ada))
Page 15 of 18 -- GLEEF Scholarship Application Form 2019 15
DECLARATON BY APPLICANT
Page 16 of 18 -- GLEEF Scholarship Application Form 2019 16
I understand that the Cathedral of the Sacred Heart GOH LUM ENG Educational Fund Board of Managementrsquos decision will be based on the information that I have provided and
Insufficient or Incomplete information given will render the application to be Rejected or Disqualified (Saya faham bahawa keputusan Lembaga Pengurusan Tabung Pendidikan Katedral Sacred Heart GOH LUM ENG adalah berdasarkan maklumat yang saya berikan Maklumat yang Tidak Cukup atau Tidak Lengkap akan menyebabkan permohonan saya ditolak atau dibatalkan)
I realise that giving false information will result in the scholarship being withdrawn and I will have to re-pay the tuition fees
(Saya sedar bahawa memberi maklumat palsu akan menyebabkan biasiswa ditarik balik dan saya dikehendaki untuk membayar balik segala yuran pengajian)
I am bonded not bonded to (any) organisation or receiving (any) financial aid from
(any) organisation (if yes please state the organisation name and the amount you have received) (Saya terikat tidak terikat kepada (mana-mana) organisasi atau menerima (mana-mana) bantuan kewangan dari (mana-mana) organisasi (jika ya sila nyatakan nama organisasi dan jumlah yang anda terima))
Name of the Organisation _________________________________________________________
1048576 Letter of Acceptance of the institution (Surat Penerimaan dari Institusi)
1048576 A letter of Recommendation from a PriestBrotherSisterPerson of standing
eg Office Bearer of CMPPCPOHDPFCSt Vincent De Paul (Surat Sokongan
dari PaderiReligius (Brother atau Sister) Orang berkedudukan Greja Pemegang Jawatan
PPCPOHDFCSt Vincent De Paul)
1048576 Other supporting documents (if any) (Dokumen sokongan lain (jika ada))
Page 15 of 18 -- GLEEF Scholarship Application Form 2019 15
DECLARATON BY APPLICANT
Page 16 of 18 -- GLEEF Scholarship Application Form 2019 16
I understand that the Cathedral of the Sacred Heart GOH LUM ENG Educational Fund Board of Managementrsquos decision will be based on the information that I have provided and
Insufficient or Incomplete information given will render the application to be Rejected or Disqualified (Saya faham bahawa keputusan Lembaga Pengurusan Tabung Pendidikan Katedral Sacred Heart GOH LUM ENG adalah berdasarkan maklumat yang saya berikan Maklumat yang Tidak Cukup atau Tidak Lengkap akan menyebabkan permohonan saya ditolak atau dibatalkan)
I realise that giving false information will result in the scholarship being withdrawn and I will have to re-pay the tuition fees
(Saya sedar bahawa memberi maklumat palsu akan menyebabkan biasiswa ditarik balik dan saya dikehendaki untuk membayar balik segala yuran pengajian)
I am bonded not bonded to (any) organisation or receiving (any) financial aid from
(any) organisation (if yes please state the organisation name and the amount you have received) (Saya terikat tidak terikat kepada (mana-mana) organisasi atau menerima (mana-mana) bantuan kewangan dari (mana-mana) organisasi (jika ya sila nyatakan nama organisasi dan jumlah yang anda terima))
Name of the Organisation _________________________________________________________
1048576 Letter of Acceptance of the institution (Surat Penerimaan dari Institusi)
1048576 A letter of Recommendation from a PriestBrotherSisterPerson of standing
eg Office Bearer of CMPPCPOHDPFCSt Vincent De Paul (Surat Sokongan
dari PaderiReligius (Brother atau Sister) Orang berkedudukan Greja Pemegang Jawatan
PPCPOHDFCSt Vincent De Paul)
1048576 Other supporting documents (if any) (Dokumen sokongan lain (jika ada))
Page 15 of 18 -- GLEEF Scholarship Application Form 2019 15
DECLARATON BY APPLICANT
Page 16 of 18 -- GLEEF Scholarship Application Form 2019 16
I understand that the Cathedral of the Sacred Heart GOH LUM ENG Educational Fund Board of Managementrsquos decision will be based on the information that I have provided and
Insufficient or Incomplete information given will render the application to be Rejected or Disqualified (Saya faham bahawa keputusan Lembaga Pengurusan Tabung Pendidikan Katedral Sacred Heart GOH LUM ENG adalah berdasarkan maklumat yang saya berikan Maklumat yang Tidak Cukup atau Tidak Lengkap akan menyebabkan permohonan saya ditolak atau dibatalkan)
I realise that giving false information will result in the scholarship being withdrawn and I will have to re-pay the tuition fees
(Saya sedar bahawa memberi maklumat palsu akan menyebabkan biasiswa ditarik balik dan saya dikehendaki untuk membayar balik segala yuran pengajian)
I am bonded not bonded to (any) organisation or receiving (any) financial aid from
(any) organisation (if yes please state the organisation name and the amount you have received) (Saya terikat tidak terikat kepada (mana-mana) organisasi atau menerima (mana-mana) bantuan kewangan dari (mana-mana) organisasi (jika ya sila nyatakan nama organisasi dan jumlah yang anda terima))
Name of the Organisation _________________________________________________________
1048576 Letter of Acceptance of the institution (Surat Penerimaan dari Institusi)
1048576 A letter of Recommendation from a PriestBrotherSisterPerson of standing
eg Office Bearer of CMPPCPOHDPFCSt Vincent De Paul (Surat Sokongan
dari PaderiReligius (Brother atau Sister) Orang berkedudukan Greja Pemegang Jawatan
PPCPOHDFCSt Vincent De Paul)
1048576 Other supporting documents (if any) (Dokumen sokongan lain (jika ada))
Page 15 of 18 -- GLEEF Scholarship Application Form 2019 15
DECLARATON BY APPLICANT
Page 16 of 18 -- GLEEF Scholarship Application Form 2019 16
I understand that the Cathedral of the Sacred Heart GOH LUM ENG Educational Fund Board of Managementrsquos decision will be based on the information that I have provided and
Insufficient or Incomplete information given will render the application to be Rejected or Disqualified (Saya faham bahawa keputusan Lembaga Pengurusan Tabung Pendidikan Katedral Sacred Heart GOH LUM ENG adalah berdasarkan maklumat yang saya berikan Maklumat yang Tidak Cukup atau Tidak Lengkap akan menyebabkan permohonan saya ditolak atau dibatalkan)
I realise that giving false information will result in the scholarship being withdrawn and I will have to re-pay the tuition fees
(Saya sedar bahawa memberi maklumat palsu akan menyebabkan biasiswa ditarik balik dan saya dikehendaki untuk membayar balik segala yuran pengajian)
I am bonded not bonded to (any) organisation or receiving (any) financial aid from
(any) organisation (if yes please state the organisation name and the amount you have received) (Saya terikat tidak terikat kepada (mana-mana) organisasi atau menerima (mana-mana) bantuan kewangan dari (mana-mana) organisasi (jika ya sila nyatakan nama organisasi dan jumlah yang anda terima))
Name of the Organisation _________________________________________________________
1048576 Letter of Acceptance of the institution (Surat Penerimaan dari Institusi)
1048576 A letter of Recommendation from a PriestBrotherSisterPerson of standing
eg Office Bearer of CMPPCPOHDPFCSt Vincent De Paul (Surat Sokongan
dari PaderiReligius (Brother atau Sister) Orang berkedudukan Greja Pemegang Jawatan
PPCPOHDFCSt Vincent De Paul)
1048576 Other supporting documents (if any) (Dokumen sokongan lain (jika ada))
Page 15 of 18 -- GLEEF Scholarship Application Form 2019 15
DECLARATON BY APPLICANT
Page 16 of 18 -- GLEEF Scholarship Application Form 2019 16
I understand that the Cathedral of the Sacred Heart GOH LUM ENG Educational Fund Board of Managementrsquos decision will be based on the information that I have provided and
Insufficient or Incomplete information given will render the application to be Rejected or Disqualified (Saya faham bahawa keputusan Lembaga Pengurusan Tabung Pendidikan Katedral Sacred Heart GOH LUM ENG adalah berdasarkan maklumat yang saya berikan Maklumat yang Tidak Cukup atau Tidak Lengkap akan menyebabkan permohonan saya ditolak atau dibatalkan)
I realise that giving false information will result in the scholarship being withdrawn and I will have to re-pay the tuition fees
(Saya sedar bahawa memberi maklumat palsu akan menyebabkan biasiswa ditarik balik dan saya dikehendaki untuk membayar balik segala yuran pengajian)
I am bonded not bonded to (any) organisation or receiving (any) financial aid from
(any) organisation (if yes please state the organisation name and the amount you have received) (Saya terikat tidak terikat kepada (mana-mana) organisasi atau menerima (mana-mana) bantuan kewangan dari (mana-mana) organisasi (jika ya sila nyatakan nama organisasi dan jumlah yang anda terima))
Name of the Organisation _________________________________________________________
1048576 Letter of Acceptance of the institution (Surat Penerimaan dari Institusi)
1048576 A letter of Recommendation from a PriestBrotherSisterPerson of standing
eg Office Bearer of CMPPCPOHDPFCSt Vincent De Paul (Surat Sokongan
dari PaderiReligius (Brother atau Sister) Orang berkedudukan Greja Pemegang Jawatan
PPCPOHDFCSt Vincent De Paul)
1048576 Other supporting documents (if any) (Dokumen sokongan lain (jika ada))
Page 15 of 18 -- GLEEF Scholarship Application Form 2019 15
DECLARATON BY APPLICANT
Page 16 of 18 -- GLEEF Scholarship Application Form 2019 16
I understand that the Cathedral of the Sacred Heart GOH LUM ENG Educational Fund Board of Managementrsquos decision will be based on the information that I have provided and
Insufficient or Incomplete information given will render the application to be Rejected or Disqualified (Saya faham bahawa keputusan Lembaga Pengurusan Tabung Pendidikan Katedral Sacred Heart GOH LUM ENG adalah berdasarkan maklumat yang saya berikan Maklumat yang Tidak Cukup atau Tidak Lengkap akan menyebabkan permohonan saya ditolak atau dibatalkan)
I realise that giving false information will result in the scholarship being withdrawn and I will have to re-pay the tuition fees
(Saya sedar bahawa memberi maklumat palsu akan menyebabkan biasiswa ditarik balik dan saya dikehendaki untuk membayar balik segala yuran pengajian)
I am bonded not bonded to (any) organisation or receiving (any) financial aid from
(any) organisation (if yes please state the organisation name and the amount you have received) (Saya terikat tidak terikat kepada (mana-mana) organisasi atau menerima (mana-mana) bantuan kewangan dari (mana-mana) organisasi (jika ya sila nyatakan nama organisasi dan jumlah yang anda terima))
Name of the Organisation _________________________________________________________
1048576 Letter of Acceptance of the institution (Surat Penerimaan dari Institusi)
1048576 A letter of Recommendation from a PriestBrotherSisterPerson of standing
eg Office Bearer of CMPPCPOHDPFCSt Vincent De Paul (Surat Sokongan
dari PaderiReligius (Brother atau Sister) Orang berkedudukan Greja Pemegang Jawatan
PPCPOHDFCSt Vincent De Paul)
1048576 Other supporting documents (if any) (Dokumen sokongan lain (jika ada))
Page 15 of 18 -- GLEEF Scholarship Application Form 2019 15
DECLARATON BY APPLICANT
Page 16 of 18 -- GLEEF Scholarship Application Form 2019 16
I understand that the Cathedral of the Sacred Heart GOH LUM ENG Educational Fund Board of Managementrsquos decision will be based on the information that I have provided and
Insufficient or Incomplete information given will render the application to be Rejected or Disqualified (Saya faham bahawa keputusan Lembaga Pengurusan Tabung Pendidikan Katedral Sacred Heart GOH LUM ENG adalah berdasarkan maklumat yang saya berikan Maklumat yang Tidak Cukup atau Tidak Lengkap akan menyebabkan permohonan saya ditolak atau dibatalkan)
I realise that giving false information will result in the scholarship being withdrawn and I will have to re-pay the tuition fees
(Saya sedar bahawa memberi maklumat palsu akan menyebabkan biasiswa ditarik balik dan saya dikehendaki untuk membayar balik segala yuran pengajian)
I am bonded not bonded to (any) organisation or receiving (any) financial aid from
(any) organisation (if yes please state the organisation name and the amount you have received) (Saya terikat tidak terikat kepada (mana-mana) organisasi atau menerima (mana-mana) bantuan kewangan dari (mana-mana) organisasi (jika ya sila nyatakan nama organisasi dan jumlah yang anda terima))
Name of the Organisation _________________________________________________________
1048576 Letter of Acceptance of the institution (Surat Penerimaan dari Institusi)
1048576 A letter of Recommendation from a PriestBrotherSisterPerson of standing
eg Office Bearer of CMPPCPOHDPFCSt Vincent De Paul (Surat Sokongan
dari PaderiReligius (Brother atau Sister) Orang berkedudukan Greja Pemegang Jawatan
PPCPOHDFCSt Vincent De Paul)
1048576 Other supporting documents (if any) (Dokumen sokongan lain (jika ada))
Page 15 of 18 -- GLEEF Scholarship Application Form 2019 15
DECLARATON BY APPLICANT
Page 16 of 18 -- GLEEF Scholarship Application Form 2019 16
I understand that the Cathedral of the Sacred Heart GOH LUM ENG Educational Fund Board of Managementrsquos decision will be based on the information that I have provided and
Insufficient or Incomplete information given will render the application to be Rejected or Disqualified (Saya faham bahawa keputusan Lembaga Pengurusan Tabung Pendidikan Katedral Sacred Heart GOH LUM ENG adalah berdasarkan maklumat yang saya berikan Maklumat yang Tidak Cukup atau Tidak Lengkap akan menyebabkan permohonan saya ditolak atau dibatalkan)
I realise that giving false information will result in the scholarship being withdrawn and I will have to re-pay the tuition fees
(Saya sedar bahawa memberi maklumat palsu akan menyebabkan biasiswa ditarik balik dan saya dikehendaki untuk membayar balik segala yuran pengajian)
I am bonded not bonded to (any) organisation or receiving (any) financial aid from
(any) organisation (if yes please state the organisation name and the amount you have received) (Saya terikat tidak terikat kepada (mana-mana) organisasi atau menerima (mana-mana) bantuan kewangan dari (mana-mana) organisasi (jika ya sila nyatakan nama organisasi dan jumlah yang anda terima))
Name of the Organisation _________________________________________________________
1048576 Letter of Acceptance of the institution (Surat Penerimaan dari Institusi)
1048576 A letter of Recommendation from a PriestBrotherSisterPerson of standing
eg Office Bearer of CMPPCPOHDPFCSt Vincent De Paul (Surat Sokongan
dari PaderiReligius (Brother atau Sister) Orang berkedudukan Greja Pemegang Jawatan
PPCPOHDFCSt Vincent De Paul)
1048576 Other supporting documents (if any) (Dokumen sokongan lain (jika ada))
Page 15 of 18 -- GLEEF Scholarship Application Form 2019 15
DECLARATON BY APPLICANT
Page 16 of 18 -- GLEEF Scholarship Application Form 2019 16
I understand that the Cathedral of the Sacred Heart GOH LUM ENG Educational Fund Board of Managementrsquos decision will be based on the information that I have provided and
Insufficient or Incomplete information given will render the application to be Rejected or Disqualified (Saya faham bahawa keputusan Lembaga Pengurusan Tabung Pendidikan Katedral Sacred Heart GOH LUM ENG adalah berdasarkan maklumat yang saya berikan Maklumat yang Tidak Cukup atau Tidak Lengkap akan menyebabkan permohonan saya ditolak atau dibatalkan)
I realise that giving false information will result in the scholarship being withdrawn and I will have to re-pay the tuition fees
(Saya sedar bahawa memberi maklumat palsu akan menyebabkan biasiswa ditarik balik dan saya dikehendaki untuk membayar balik segala yuran pengajian)
I am bonded not bonded to (any) organisation or receiving (any) financial aid from
(any) organisation (if yes please state the organisation name and the amount you have received) (Saya terikat tidak terikat kepada (mana-mana) organisasi atau menerima (mana-mana) bantuan kewangan dari (mana-mana) organisasi (jika ya sila nyatakan nama organisasi dan jumlah yang anda terima))
Name of the Organisation _________________________________________________________
1048576 Letter of Acceptance of the institution (Surat Penerimaan dari Institusi)
1048576 A letter of Recommendation from a PriestBrotherSisterPerson of standing
eg Office Bearer of CMPPCPOHDPFCSt Vincent De Paul (Surat Sokongan
dari PaderiReligius (Brother atau Sister) Orang berkedudukan Greja Pemegang Jawatan
PPCPOHDFCSt Vincent De Paul)
1048576 Other supporting documents (if any) (Dokumen sokongan lain (jika ada))
Page 15 of 18 -- GLEEF Scholarship Application Form 2019 15
DECLARATON BY APPLICANT
Page 16 of 18 -- GLEEF Scholarship Application Form 2019 16
I understand that the Cathedral of the Sacred Heart GOH LUM ENG Educational Fund Board of Managementrsquos decision will be based on the information that I have provided and
Insufficient or Incomplete information given will render the application to be Rejected or Disqualified (Saya faham bahawa keputusan Lembaga Pengurusan Tabung Pendidikan Katedral Sacred Heart GOH LUM ENG adalah berdasarkan maklumat yang saya berikan Maklumat yang Tidak Cukup atau Tidak Lengkap akan menyebabkan permohonan saya ditolak atau dibatalkan)
I realise that giving false information will result in the scholarship being withdrawn and I will have to re-pay the tuition fees
(Saya sedar bahawa memberi maklumat palsu akan menyebabkan biasiswa ditarik balik dan saya dikehendaki untuk membayar balik segala yuran pengajian)
I am bonded not bonded to (any) organisation or receiving (any) financial aid from
(any) organisation (if yes please state the organisation name and the amount you have received) (Saya terikat tidak terikat kepada (mana-mana) organisasi atau menerima (mana-mana) bantuan kewangan dari (mana-mana) organisasi (jika ya sila nyatakan nama organisasi dan jumlah yang anda terima))
Name of the Organisation _________________________________________________________
Amount Received _________________________________________________________
Signature __________________ Date ______________________
Name _____________________ IC No _____________________
Page 17 of 18 -- GLEEF Scholarship Application Form 2019 17
REFEREES
Name (MrMrsMsRev)
Address
Tel Mobile
Occupation
Signature
Name (MrMrsMsRev)
Address
Tel Mobile
Occupation
Page 18 of 18 -- GLEEF Scholarship Application Form 2019 18
FOR OFFICE USE ONLY
Date Received
Date Acknowledged
Interviewed 1048576 Yes
1048576 No Notes on interview
1048576 Accept- Unconditional Offer
1048576 Accept- Conditional Offer Conditions
1048576 Decline -
Reasons Total amount awarded RM _______________________ Payable in manner and time as follows
Signed by Applicant _______________________
Date _________________
Page 15 of 18 -- GLEEF Scholarship Application Form 2019 15
DECLARATON BY APPLICANT
Page 16 of 18 -- GLEEF Scholarship Application Form 2019 16
I understand that the Cathedral of the Sacred Heart GOH LUM ENG Educational Fund Board of Managementrsquos decision will be based on the information that I have provided and
Insufficient or Incomplete information given will render the application to be Rejected or Disqualified (Saya faham bahawa keputusan Lembaga Pengurusan Tabung Pendidikan Katedral Sacred Heart GOH LUM ENG adalah berdasarkan maklumat yang saya berikan Maklumat yang Tidak Cukup atau Tidak Lengkap akan menyebabkan permohonan saya ditolak atau dibatalkan)
I realise that giving false information will result in the scholarship being withdrawn and I will have to re-pay the tuition fees
(Saya sedar bahawa memberi maklumat palsu akan menyebabkan biasiswa ditarik balik dan saya dikehendaki untuk membayar balik segala yuran pengajian)
I am bonded not bonded to (any) organisation or receiving (any) financial aid from
(any) organisation (if yes please state the organisation name and the amount you have received) (Saya terikat tidak terikat kepada (mana-mana) organisasi atau menerima (mana-mana) bantuan kewangan dari (mana-mana) organisasi (jika ya sila nyatakan nama organisasi dan jumlah yang anda terima))
Name of the Organisation _________________________________________________________
Amount Received _________________________________________________________
Signature __________________ Date ______________________
Name _____________________ IC No _____________________
Page 17 of 18 -- GLEEF Scholarship Application Form 2019 17
REFEREES
Name (MrMrsMsRev)
Address
Tel Mobile
Occupation
Signature
Name (MrMrsMsRev)
Address
Tel Mobile
Occupation
Page 18 of 18 -- GLEEF Scholarship Application Form 2019 18
FOR OFFICE USE ONLY
Date Received
Date Acknowledged
Interviewed 1048576 Yes
1048576 No Notes on interview
1048576 Accept- Unconditional Offer
1048576 Accept- Conditional Offer Conditions
1048576 Decline -
Reasons Total amount awarded RM _______________________ Payable in manner and time as follows
Signed by Applicant _______________________
Date _________________
Page 16 of 18 -- GLEEF Scholarship Application Form 2019 16
I understand that the Cathedral of the Sacred Heart GOH LUM ENG Educational Fund Board of Managementrsquos decision will be based on the information that I have provided and
Insufficient or Incomplete information given will render the application to be Rejected or Disqualified (Saya faham bahawa keputusan Lembaga Pengurusan Tabung Pendidikan Katedral Sacred Heart GOH LUM ENG adalah berdasarkan maklumat yang saya berikan Maklumat yang Tidak Cukup atau Tidak Lengkap akan menyebabkan permohonan saya ditolak atau dibatalkan)
I realise that giving false information will result in the scholarship being withdrawn and I will have to re-pay the tuition fees
(Saya sedar bahawa memberi maklumat palsu akan menyebabkan biasiswa ditarik balik dan saya dikehendaki untuk membayar balik segala yuran pengajian)
I am bonded not bonded to (any) organisation or receiving (any) financial aid from
(any) organisation (if yes please state the organisation name and the amount you have received) (Saya terikat tidak terikat kepada (mana-mana) organisasi atau menerima (mana-mana) bantuan kewangan dari (mana-mana) organisasi (jika ya sila nyatakan nama organisasi dan jumlah yang anda terima))
Name of the Organisation _________________________________________________________
