Please click here to the application form

SIVADAS-HEB EDUCATION FUND
TERTIARY STUDENTS EDUCATION ASSISTANCE SCHEME
APPLICATION FORM
This application is for: Education Grant / Tuition Subsidy *
NOTES TO APPLICANTS: The application form is to be completed by the student applying for assistance.
 Applicants who have previously applied for and received the Education Grant or
Tuition Subsidy need not apply again.
 The application form must be endorsed by the Parent or Guardian if the applicant is
below the age of 18.
 Applicants must attach copies of educational certificates and documents with the
application and produce orginals when called for an interview.
 Details of all family members living in the same household must be included
 Please provide a copy of the latest payslip, income declaration or letter from employer
for all employed members of the family who are living in the same household.
 Please provide a copy of Student IC, Student ID Proof & Parents IC.
 Endorsement by student affairs department of private tertiary institute.
 Closing date for applications is 17 June 2015.

Please delete accordingly
(I) APPLICANT’S PARTICULARS (AS IN I/C)
Name :
Date of Birth : ___________________
Gender :
IC No
: __________________
Citizenship
:
Singaporean / PR *
Race
Male / Female *
: _____________________
Religion : _____________________
Marital Status :
Single / Married / Separated / Widowed / Divorced *
Home Address: Blk _________________
Unit No. # _________________________
Street Name : ____________________________________________________________________
Postal Code : _______________________
Tel No : ___________________________ (Home) ________________________ (Mobile / HP) (compulsory)
Email : ____________________________________________(compulsory)
Type of Dwelling:1-room / 2- room / 3-room / 4-room / 5-room / Others (pls specify) * : ____________________________
Ownership: Purchased / Rental*
Occupation (if not working, state “Unemployed” and duration of unemployment)
Name and Address of Employer
Gross Monthly Income (Total Income before CPF deduction, excluding allowances, if any)
Part II-A - To be completed by applicants for Tuition Subsidy
Part II-B - To be completed by applicants for Education Grant
(II-A) To be completed by applicants for Tuition Subsidy
Name of Private Institution:
____________________________________________________________________________________________
Address : ________________________________________
Tel No : __________________________________
Name of Degree/ Diploma:
____________________________________________________________________________________________
Name of Conferring Institute:
____________________________________________________________________________________________
Month/Year Started/ Starting: __________________ Expected Month/Year of Completion: ___________________
Total Fees: ______________
(Please attach a schedule of fees payable)
Fee Breakdown
Year
Fee (S$)
Schools attended, excluding the one in which you are currently enrolled. In sequence, list your most recent
institution first (please attach transcripts for each institution, where necessary)
Year Started
Year Completed
Name of Institute
Qualification Earned
Part II-B - To be completed by applicants for Education Grant
Name of Local Tertiary Institute: ________________________________________________________________
Year of Study/ Matriculation or Student ID Number: _____________________________________
Please provide documentary proof of Admission to Tertiary Institute
(III) EDUCATION ASSISTANCE RECEIVED / APPLIED FOR
Are you receiving any educational assistance currently?
Yes / No *
(if yes, please provide details)
Name of Organisation
Amount
(IV) PARTICULARS OF ALL FAMILY MEMBERS (WITHIN HOUSEHOLD)
Name
Relationship to
Applicant
NRIC
Date
of
Birth
Education
Level
Occupation
Self
Total ($)
Gross
Monthly
Income
(V) DECLARATION TO BE COMPLETED BY APPLICANT AND PARENT OR GUARDIAN (IF
APPLICANT IS BELOW 18 YEARS)
1. I hereby declare that the particulars contained in this application are true and correct.
2. I understand that the committee reserves the right to verify the above information in whatever means deemed fit
and necessary. I understand that any misreporting of the above information can lead to my application being
rejected.
3. I understand that the acceptance of this application form by the Sivadas-HEB Education Fund does not bind the Fund
to approve the application and the committee’s decision is final.
4. I will endeavour to study hard and complete the course, to the best of my ability.
________________________________
Name of Applicant
_______________________
Signature of Applicant
_____________
Date
I consent and will support my child who is making this application as a minor (below 18 years of age)
___________________________________
Name of Parent / Guardian
________________________
Signature of Parent / Guardian
____________
Date
(VI) ENDORSEMENT BY STUDENT AFFAIRS DEPARTMENT OF PRIVATE TERTIARY
INSTITUTE
I confirm that Student (name) ____________________, IC No:_________________, is enrolled / has been
offered a place* in our Institution to pursue a course in _______________ leading to the award of
(qualification) ________________ commencing on ____________.
___________________________________
Name & Designation
________________________
Signature
____________
Date
___________________________________
Name / Stamp / Seal of PEI
(VII) FOR OFFICIAL USE
Application : Approved / Not Approved
Amount Approved: $____________ for the period ___________to ______________.
Remarks
:
__________________________________________________________________________
Approved by: Signature:
:__________________
______________________
_______________
Name and Date :__________________
______________________
________________
You may mail or fax or handover in person the completed form with the supporting documents to:
Sivadas – HEB Education Fund
c/o Hindu Endowments Board
397, Serangoon Road, Singapore 218123
Tel: 6593 9209, Fax: 6292 9766
Web Site: www.heb.gov.sg E mail: shetf@heb.gov.sg