LEF ApplicationForm
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Transcript of LEF ApplicationForm
8/12/2019 LEF ApplicationForm
http://slidepdf.com/reader/full/lef-applicationform 1/5
* Please fill up all details in BLOCK letters or circle if applicable.
Name (Eng):
NRIC No.: Gender: Age:
Date of Birth: ____ (dd)/ ____ (mm)/ _______ (yy)
Permanent
Address:
Tel. No.: H/P: Others:
Correspondence
Address:(If different from
the above)
Email Address:
Highest Academic Qualication Obtained:
Extra-Curricular Activities (Organisation/Position):
Awards Obtained (Academic or Extra-Curricular Activities):
Name of Institution of Higher Learning:
Name of Course:
Course Duration (Total No. of years): Expected Course Completion:
Total Course Fees per year: RM .
I hereby certify that all the information provided above is true and correct.
Applicant's Date:Signature:
LEAr N FUND APPLICATION FORM
F / M
PERSONAL DETAILS OF APPLICANT
(Chinese):
(mm) (yy)
1)
2)
3)
1)
2)
3)
Current Year of Study in Course (eg. 1st year, 2nd year):
RM
RM
If you have received other scholarships or loans, please state scholarship name(s) & amount(s):
If you have applied for other scholarships or loans, please state scholarship name(s):
1) 2)
Nationality:
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Recent
Passport
Size
Photograph
8/12/2019 LEF ApplicationForm
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Guarantor's Name (Eng):
NRIC No.: Date of Birth: ___ (dd)/ ____ (mm)_______ (yy)
Gender: F / M
Occupation: Monthly Income:
Home Address:
Tel. No.: H/P: Email:
Employer's or Company's Name & Address:
Tel. No.: Fax No.:
I hereby certify that all the information provided above is true and correct.
Guarantor's Date:
Signature:
Guarantor's Name (Eng):
NRIC No.: Date of Birth: ___ (dd)/ ____ (mm)_______ (yy)
Gender: F / M
Occupation: Monthly Income:
Home Address:
Tel. No.: H/P: Email:
Employer's or Company's Name & Address:
Tel. No.: Fax No.:
I hereby certify that all the information provided above is true and correct.
Guarantor's Date:
Signature:
Relationship to Applicant:
RM
PERSONAL DETAILS OF GUARANTORS (2)
LEAr N FUND APPLICATION FORM
PERSONAL DETAILS OF GUARANTORS (1)
RM
Relationship to Applicant:
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(Chinese):
(Chinese):
8/12/2019 LEF ApplicationForm
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1 Father/Guardian
Name: (Eng)
NRIC No.: Date of Birth: ____ (dd)/ _____ (mm)/ _______(yy)
Occupation: Monthly Income:
2 Mother/Guardian
Name: (Eng)
NRIC No.: Date of Birth: ____ (dd)/ _____ (mm)/ _______(yy)
Occupation: Monthly Income:
3 Siblings
No. of Siblings: No. of siblings in full-time education:
Age
No. of siblings under employment:
I hereby certify that all the information provided above is true and correct.
Applicant's Date:
Signature:
Name Name of School / College / University
FAMILY BACKGROUND OF APPLICANT
LEAr N FUND APPLICATION FORM
RM
RM
(Chinese):
(Chinese):
Occupation Monthly Income
RM
RM
RM
RM
RM
Name
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8/12/2019 LEF ApplicationForm
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Referred by Lions Club of ______________________________
President's Secretary's
Signature: Signature:
President's Name: _______________________________ Secretary's Name: ___________________________
Date: _______________________________ Date: ___________________________
a) All applicants must fill in the official application forms of LEAr N Fund and affix a non-returnable latest passport
size photograph. Completed forms should be returned to: LEAr N Fund Selection Department.
Lions Selection Commi ttee
B-10-5, Block B, Megan Avenue 1,
189 Jalan Tun Razak, 50400 Kuala Lumpur.
b) Incomplete forms will not be entertained.
* SPM or STPM examination results
* SPM or STPM preliminary examination results
* School Testimonial and School Leaving Certificates
* All other certificates stated in the application form
* Identity Card
* Offer Letter from the Higher Education Institution stating the course name, course structure and fee structure
* EPF statement, income tax statement or any other proof of income of parents/guardians and/or siblings
* Two guarantors are required for this application
* One of the guarantors must be the parent/guardian of the applicant
* A copy of the identity card of the guarantor must be provided
* The guarantor must not be a bankrupt or undergoing bankruptcy proceedings
LEAr N FUND APPLICATION FORM
Please state briefly your main reasons for applying LEAr N Fund study aid:
APPLICATION PROCEDURE
c) Applicants must enclose certified copies of the following documents:
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8/12/2019 LEF ApplicationForm
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LEAr N Fund:
Lions Education Assistance for the Needy Fund.
Lions Selection Committee:
The committee members appointed to carry out the interview session/s with the applicants and to decide on their
eligibility and the study aid value.
LEAr N Fund Agreement:
An official agreement between the applicant and Lions Education Foundation with all the terms and conditions stated
therein.
Study Aid:
Amount granted to the applicant by the LEAr N Fund.
1.1. The Applicant must be a Malaysian pursuing full time higher education and gained admission into any private or
public Institutions of higher learning (colleges or universities) in any academic disciplines in Malaysia excluding
drama, singing artists, beauty and the like.
1.2. The Institution of higher learning must be recognized by the Ministry of Education of Malaysia.
1.3. The Applicant must possess consistent and satisfactory academic records and/or active participation in
extracurricular activities in school.
1.4. The Applicant must not be older than 20 years for Diploma programmes and not older than 25 years for Degree
programmes.
1.5. The combined income of the parents must not exceed RM30,000 per annum.
2.1. The Applicant must be recommended or referred by any of the Lions Clubs in Malaysia.
2.2. The Applicant must attend an interview session conducted by the Lion Selection Committee and agreed that the
decisions made by the said committee are final and shall not be challenged.
2.3. Successful Applicant shall be bound by the terms and conditions set out in the LEAr
N Fund Agreement.
3.1. The study aid is Ringgit Malaysia Five Thousand (RM5,000) per annum only.
3.2. The Applicant shall be bound by the study aid repayment schedule set out in the LEAr N Fund Agreement
unless he/she secured a minimun CGPA3.80 and above for each and every semester term.
3.3. The life of the applicant shall be insured by Lions Education Foundation covering the study aid.
LEAr N FUND APPLICATION FORM
DEFINITION
1. APPLICANT'S ELIGIBILITY
2. APPLICANT'S OBLIGATIONS
3. STUDY AID COVERAGE
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