1. Healthcare

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Application for the admission of Category E applicants to undergraduate courses in Academic Year 2015-2016
Please check your application before submission. The Office of Admissions cannot be held responsible for the accuracy of
your application.
As you are on a secure site, and for security reasons, please note that you are only given 30 minutes to complete the application form. You will be logged out if you take more
than the allocated time.
Fields that are marked with * are mandatory.
1. Personal
Particulars
Full Name *
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The application form consists of the following sections. Please complete all sections.
7.
Disabilities and Special Needs
1. Personal Particulars
2. Contact Information
8.
Next-of-Kin Information
3.. Academic Qualifications
9.
Personal Identification Number
4. University/Tertiary Education
10.
Application Fee
5. Choice of Courses
11.
Financial Aid
6. National Service and Employment History
12.
Other Information
13.
Declaration
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(e.g. TAN KOK LENG)
(full name as printed on your NRIC/passport/Birth Certificate)
Given Name *
(e.g. KOK LENG)
Note: Click here for guide on how to key in Given Name
Family Name *
(E.g. TAN)
Note: Click here for guide on how to key in Family Name
Date of Birth *
/
Gender *
Citizenship *
Singapore Permanent Resident
NRIC number/FIN
Yes
S
Passport Number
(dd / mm / yyyy
eg. 08 / 02 / 1989)
No (Please do not select ‘Yes’ if you are a Singapore Citizen.)
(To be filled in by non-Singapore Citizen. If you are a Malaysian, please enter your 12-digit Malaysian I/C
number)
M
Marital Status*
/
Race / Ethnic Group*
Religion*
2. Contact
Information
Postal Address *
(e.g. APT BLK 42)
SA
Block/HouseNo. *
Street Name/Building Name *
Unit No.
State/City
(You do not need to fill in "Singapore" here if you are providing a
Singapore address)
(e.g. #12-34)
Country *
Postal Code
Email *
(Please ensure your email address will be in-use for at least
another 12 months)
Alternate Email
Home
Telephone*
(Please ensure your alternate email is different from the above)
Country
Area
Number
(Please do not fill in country & area codes for Singapore number; for the
'number' field, please do not put hyphen or leave space in-between numbers,
eg. Contact number should be keyed in as 12345678)
Country
Area
Number
(Please do not fill in country & area codes for Singapore number; for the
'number' field, please do not put hyphen or leave space in-between numbers,
eg. Contact number should be keyed in as 12345678)
Handphone
3. Academic Qualifications
Secondary Education
Name of Secondary School
City/Country
From
Examination
Subjects
To
Year Taken
Marks / Grade
Obtained
Maximum Marks / Grade
Possible
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English
Additional Mathematics
Physics
The above information is required to ascertain that you satisfy specific course pre-requisites. You may not have offered
some of these subjects therefore information is not compulsory. Please leave the space blank if you have not taken the
above subjects.
High School Education*
Name of High School
Enter Name of High School if not
found in list
Examination
City/Country
From
To
S'PORES'PORE-CAMBRIDGE GCE 'A' LEVEL Year
Taken
Type of results submitted
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Actual
Please ensure that the information you enter is accurate as your admission outcome will be adversely
affected by inaccurate information.
Examination Results
Level
Subject
Additional Information
M
Please provide, if available
Grade
Date Taken
SA
IELTS (Please input the
score for Academic
testing only)
TOEFL
Marks / Grade Obtained
(Please enter
Overall band
component score only)
(Please enter
Writing component
score only)
(Please enter
Reading component
score only)
Paper
Internet
EL1119
MUET
SAT
Critical Reading
Math
Writing
SAT Subject Tests
Subject
ACT Composite Score
Advanced Placement
(AP)
Subject
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Students who are offering the Indian Standard 12 qualification may fill in their IIT/AIEEE (if applicable) below:
AIEEE Rank
State Rank
Country Rank
IIT Rank
State Rank
Country Rank
Reason for transfer (please limit to 1500 characters)
1500
chars remaining
4. University/Tertiary Education
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Please provide your reason(s) for seeking a transfer which would assist the University to assess your application. Please leave this blank if you are a high school
student who have not enrolled into a University.
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Q1.Have you graduated from the National University of Singapore, Yale-NUS college, Nanyang Technological University,
Singapore University of Technology and Design, Singapore Management University, SIM University, or Singapore
Institue of Technology?
Yes
No
Q2.Are you a current student of National University of Singapore, Yale-NUS college, Nanyang Technological University,
Singapore University of Technology and Design, Singapore Management University, SIM University, or Singapore
Institue of Technology?
Yes
No
Yes
No
M
Q3.Are you a former student of National University of Singapore, Yale-NUS college, Nanyang Technological University,
Singapore University of Technology and Design, Singapore Management University, SIM University, or Singapore
Institue of Technology seeking readmission?
Q4.Are you a current / former student of any other university or tertiary institutions (except polytechnics in Singapore)?
Yes
No
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If you have chosen YES to the questions Q1, Q2, or Q3, please provide your academic results as follows
University
From
To
Course
Matriculation/Student Identification Number
If you are still taking the module(s), please input results and CAP as "IP".
Year
Semester/Term
Subject
https://myaces.nus.edu.sg/uasonline2/catE/catESetupB.do
Marks / Grade
Obtained
Maximum
Marks /
Grade Possible
GPA/CAP
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Please indicate if you were ever on LOA (Leave of Absence) during your course of study
LOA start month & year
LOA end month & year
Please indicate number of semesters spent (including current)
Are you on the University Scholars Programme (USP)?
Yes
Are you currently pursuing a double degree programme (DDP) in NUS?
Yes
No
Are you withdrawing from the current double degree programme (DDP) in NUS?
(Please choose “Not Applicable” if you are currently not on the DDP)
Yes
No
Not applicable
Are you changing your home faculty for your current double degree programme (DDP) in NUS?
(Please choose “Not Applicable” if you are currently not on the DDP)
Yes
No
Not applicable
5. Choice of Courses
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Are you a scholarship holder?
No
Yes
No
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There will be TWO parts in this section: (a) and (b).
In (a), please tell us your choice of Single Degree courses in order of your preference. You must complete (a) before you proceed to (b) to indicate your
interest in the Double/Concurrent Degree programmes.
You need to complete (b) only if you are interested in the double/concurrent degree programmes.
a) Single Degree Courses
State your choice of course in order of preference. We will consider your choice in the order that you have indicated. For example, if you do not qualify for your first
choice, we will consider you for your second choice and so forth, at no disadvantage. You may choose fewer than 8 choices but do not repeat the choices. For the latest
update on courses, please refer to http://www.nus.edu.sg/oam/courses/course.html.
1st Choice*
2nd Choice
3rd Choice
4th Choice
5th Choice
6th Choice
7th Choice
8th Choice
z
z
M
Note: For each choice, there is a Drop-Down-Menu comprising all single-degree courses which NUS offers
Application for the Music course should be filed separately. Please refer to the Yong Siew Toh Conservatory of Music (NUS) website at http://music.nus.edu.sg
Students reading common Engineering will be streamed at the end of Year 1 to Biomedical Engineering, Chemical Engineering, Civil Engineering, Computer
Engineering, Electrical Engineering, Environmental Engineering, Industrial & Systems Engineering, Mechanical Engineering or Materials Science & Engineering
z Students must indicate Dentistry as their first or second choice if they wish to be considered for admission to this course.
z Students must indicate Medicine as their first or second choice if they wish to be considered for admission to this course.
z Students must indicate Nursing as their first, second or third choice if they wish to be considered for admission to this course.
z Students must indicate Architecture as their first, second or third choice if they wish to be considered for admission to this course.
z Students must indicate Industrial Design as their first, second or third choice if they wish to be considered for admission to this course.
z Students must indicate Law as their first or second choice if they wish to be considered for admission to this course.
b) Double/Concurrent Degree Programmes
z
Please fill in this section if you are interested in a double/concurrent degree programme.
SA
Note that:
1. If you wish to apply for a double/concurrent degree programmes, you must include at least one of the faculties/schools offering the double/concurrent degree
programme as one of your choices in (a).
2. The faculties / schools offering direct admission to double / concurrent degree programmes are Arts & Social Sciences (for Economics and Communications & New
Media), Business, Computing, Engineering (except Engineering Science course), Law and Science (for Mathematics/Applied Mathematics and Life Sciences).
3. To be considered for the Business Administration & Law, Business Administration(Accountancy) & Law, Economics & Law, Law & Life Sciences, and/or Law &
Master in Public Policy double/concurrent degree programmes, you must have listed Law as your first or second choice in the selection of a single degree course in
(a). For more information, please click here.
4. To be considered for the Mathematics/Applied Mathematics & Computing (Computer Science) double degree programme, you must have listed Science and/or
Computing (Computer Science) as one of your choices in (a).
5. To be considered for the Computing (Computer Science with Specialisation in Computational Biology) & Scientiae Magister in Computer Science-Computational
Biology track (Brown University) concurrent degree programme, you must have listed Computing (Computer Science) as one of your choices in (a).
6. To be considered for the Computing (Computer Science) & Grad Scientiae Magistri (Scientia Computatoria) (Brown University) concurrent degree programme, you
must have listed Computing (Computer Science) as one of your choices in (a).
7. To be considered for the Computing (Information Systems) and Master of Science (Management) (NUS) concurrent degree programme, you must have listed
Computing (Information Systems) as one of your choices in (a).
You will be evaluated for admission to a double/concurrent degree programme if you are successful in gaining admission into a faculty /school that offers one of the
double/concurrent degree programmes.
Some double/concurrent degree programmes require a selection interview. Only shortlisted candidates will be informed to attend the interview(s) for the
double/concurrent degree programmes. You may be shortlisted for one or more interviews if you indicate more than one choice for your Double/Concurrent Degree
Programme options. Please note that Double/Concurrent Degree Programmes are highly competitive.
If you are interested in more than one double/concurrent degree programme, please select the programmes in order of preference.
1st
Choice
2nd
Choice
3rd
Choice
4th
Choice
Note: For each choice, there is a Drop-Down-Menu comprising:
z
z
z
Business Administration & Communications and New Media
Business Administration (Accountancy) & Communications and New Media
Business Administration & Computing (Computer Science)
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z
z
z
z
z
z
z
z
z
z
z
z
z
z
z
z
z
z
z
z
z
Business Administration & Computing (Information Systems)
Business Administration (Accountancy) & Computing (Computer Science)
Business Administration (Accountancy) & Computing (Information Systems)
Business Administration & Law
Business Administration (Accountancy) & Law
Business Administration & Master of Science (Management)
Business Administration (Accountancy) & Master of Science (Management)
Business Administration & Master in Public Policy
Business Administration (Accountancy) & Master in Public Policy
Engineering (Except Engineering Science) & Business Administration
Engineering (Except Engineering Science) & Business Administration (Accountancy)
Engineering (except Engineering Science) and Economics
Economics and Business Administration
Economics and Business Administration (Accountancy)
Economics and Law
Law and Master in Public Policy
Law and Life Sciences
Mathematics/Applied Mathematics & Computer Science
Computing (Computational Biology) & Scientiae Magister in Computer Science-Computational Biology track (Brown University)
Computing (Computer Science) & Grad Scientiae Magistri (Scientia Computatoria) (Brown University)
Computing (Information Systems) and Master of Science (Management) (NUS)
6. National Service and Employment History
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Please click here for more information on NS Status before completing this section.
Please choose "Not Applicable" if you do not need to or are not serving National Service in Singapore.
PL
E
If you are waiting to be enlisted for NS, please select "Registered/Waiting to be enlisted" for your "NS Status." Unless
you have indicated your NS status as "Not Applicable", "Registered" or "Exempted", you are required to indicate your
NS date.
National Service
Status *
Enlistment Date
(Not applicable if your NS status is "NA" or "EXEMPTED" or "Registered".)
ORD/Disruption Date
If you are exempted from National Service, you are required to submit the necessary documents (endorsed by MINDEF) to Office of Admissions. Please click here
for more information on submission of supporting documents.
Employment History
If you are at least 25 years old as of 1 July 2015 with at least 4 full years of relevant full-time working experience, would you
like to be considered as a Mature Candidate?
Yes
No
If you have answered "Yes", please complete both Parts (a) and (b) in this section.
(a) Particulars of Referrals
Name of Company
Name of Referee
Telephone number
M
Please provide 2 referrals (compulsory) from at least one employer. Referrals must be at supervisory level and above.
Referee 1
(Country & area codes are required only for non-Singapore number)
Country
Referee 2
Number
SA
Name of Company
Area
Name of Referee
Telephone number
Country
Area
(Country & area codes are required only for non-Singapore number)
Number
(b) Employment History
Please indicate the name of the company and length of service with each employer which makes up the 4 full years of relevant
working experience, starting from the most current employer.
Name of Company
Position
From
To
(c) SAT Test Scores
Please provide your SAT Test scores in Section 6 of this Form if you have indicated that you wish to be considered as a Mature
Candidate.
7. Disabilities and Special Needs
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Have you had or do you have any communicable diseases, mental illness, colour blindness, and/or disabilities
(including but not limited to chronic illnesses, visual or other physical constraints or limitations) which may or may
not cause you to require special assistance or facilities while studying at the University? *
Yes
No
If yes, please provide details below and submit medical documents and/or other supporting documents.
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Medical conditions
Please provide more details on your medical condition in the box
Medical condition 1:
250
chars remaining
250
chars remaining
250
chars remaining
Medical condition 2:
Medical condition 3:
1000
chars remaining
PL
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If you require any form of special assistance and/or facilities if admitted to the University, please provide details
below.
Note: This information will enable the University to develop a complete profile of an applicant and determine
whether he/she might need additional resources in his/her studies. The University does not, however, guarantee
the provision of special aid (financial or otherwise) to any student.
8. Next-of-Kin Information
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Please provide a contact person in case of an emergency.
Name of Next-of-Kin /
Guardian *
Relationship with Applicant*
Occupation *
Telephone *
(country & area codes are required only for non-Singapore number)
Country
Area
Number
Country
Area
Number
Handphone / Pager
(country & area codes are required only for non-Singapore number)
9. Personal Identification Number
(8 alpha-numeric characters e.g. gwWg254x)
M
Enter an Admission PIN (8 alpha-numeric characters)
(case sensitive)*
Re-enter your Admission PIN (8 alpha-numeric characters)
(case sensitive)*
Please keep your PIN confidential. Your PIN is important and you will need it to access the following online facilities related
to this application.
z
z
z
z
z
Uploading of supporting documents
Online status enquiry
Online reply to NUS' offer of admission
Online appeal
E-Payment via Credit Card
SA
10.Application Fee
A non-refundable application fee of SGD10 is payable. Please select one of the following modes of payment
Credit card [Visa/ MasterCard/ Amex only]/ Internet Banking. Payment can be made immediately via the web
link located at the acknowledgement page after submitting your application.)
Bank draft/cheque made payable to 'National University of Singapore'
NETS at the Office of Admissions, NUS
* Payment must be made by 21 February 2015. Applications without full payment will not be processed.
11.Financial Aid
NUS offers Financial Aid schemes such as loans, bursaries and work-study opportunities in order to help financially
needy students meet their study expenses in NUS.
Do you intend to apply for Financial Aid offered by NUS to support your studies in NUS? *
Yes
No
12.Other Information
Have you ever been convicted of an offence by a court of law or a military court (court martial) in any country or
are there any court proceedings pending against you anywhere in respect of any offence?
Are you currently, or have you ever been, charged with or subject to disciplinary action for any type of
misconduct, scholastic or otherwise, at any educational institution?
Are you currently, or have you ever been, under investigation or subject to enquiry in respect of any
misconduct, scholastic or otherwise, at any educational institution?
If your answer to all the above questions is ‘No’, please click ‘No’ below. *
No
Or
If your answer to any or all of the above questions is ‘Yes’, please click ‘Yes’ below and also provide a full
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statement of the relevant information in the box below and/or on a separate sheet of paper (and attach the relevant
documents).
Yes
100
chars remaining
13.Declaration
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I hereby declare that all information provided by me in connection with this application is true, accurate and complete.
I understand that any inaccurate, incomplete or false information given or any omission of information required shall
render this application invalid and NUS may at its discretion withdraw any offer of acceptance made to me on the basis
of such information or, if already admitted, I may be liable to disciplinary action, which may result in my expulsion
from NUS. And I hereby authorise NUS to obtain and verify any part of the information given by me from or with any
source (such as Ministry of Education), as it deems appropriate.
I declare and warrant that for any personal data of other individuals disclosed by me in connection with this
application, I have, prior to disclosing such personal data to NUS, obtained the appropriate consent from the
individuals whose personal data are being disclosed, to permit NUS to collect, use and disclose such personal data for
purposes related to this application, as set out fully in the Personal Data Notice & Consent.
PL
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I agree that all such information provided by me in connection with this application may be disclosed to authorised NUS
personnel or third parties on a need-to-know basis for purposes related to this application, as set out fully in the
Personal Data Notice & Consent. Third parties include (i) the Ministry of Education, other government agencies or
statutory bodies or non-government agencies authorised to carry out specific Government services or duties and (ii)
persons or organisations providing students with financial aid.
I have read and agree to the terms and conditions contained in the Personal Data Notice & Consent.
I agree to receive marketing, advertising and promotional information from NUS via postal mail, electronic mail, SMS
or MMS and/or fax.
Yes
No
I agree to receive marketing, advertising and promotional information from NUS at my telephone number provided
above via voice call / phone call.
Yes
No
Continue
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