MaybankScholarshipForm2012-01-20

8/2/2019 MaybankScholarshipForm2012-01-20

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Maybank Scholarship Award Application Form

Instructions to Applicants

1. PLEASE READ the instructions in detail. Incomplete application forms and applications that do not

comply the requirements will NOT be considered.

2. All applications and documents are to be sent in soft copy to [email protected] with thesubject Maybank Scholarship Application YOUR FULL NAME.

3. Before completing this form, please ensure that you have Macros enabled.

MS Office 2003 version

Tools > Macro > Security

Select Medium/Lowsecurity level

MS Office 2007 version

Word Options > Trust Centre > Trust Centre Settings > Macro Settings

4. Applications need to comply with the following requirements:

i. The application form is to be completed in English.

ii. All fields are compulsory. For fields that do not apply to you (e.g. Monetary Aidif you did

not receive loans/scholarships), please indicate N/A.

iii. Certified English translations of supporting documents (i.e. certificates, testimonials and

transcripts) must be submitted for documents that are not in English, Bahasa Malaysia, or

Bahasa Indonesia.

5. Applicants must attach soft copies of the following documents as part of their application:

Application Form (saved in .DOC or .DOCX format, renamed to your full name with your

identification/passport number)

e.g. Abu Bin Ahmad (A12345678).DOCX

Recent Passport-size photo

Identification Card or Passport (front & back)

o Applicant

o Both parents and/or guardian(s)

o Both guarantors

Scanned copies of academic certificates & transcripts (SPM / O-Levels / UEC / STPM / A-

Levels / SAM / CPU / Matriculation / Diploma / IB / etc.)

Testimonial and recommendation letter from school/university

Leaving school certificate / Sijil berhenti sekolah

Co-curricular certificate(s), etc.

Latest Income Tax Return, EA Form, and payslip of Parents/Guardian(s) and Siblings (if any)

University acceptance letter

6. All attached documents can be in any of these formats:

DOC, DOCX

PDF GIF

JPG

Applicants may only attach up to a maximum combined file size of 3MB.

7. All applications must reach Maybank Scholarship Committee by 18 February 2012. Applications

received after this date will not be considered.

8. Successful applicants will be notified via e-mail and/or telephone.
mailto:[email protected]:[email protected]


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Preferred Degree Details

Preferred Course Bachelor

Preferred University Campus Course Application Date (mm/yyyy) Application Status PendingIntake (mm/yyyy)Course Fee Per Year * * Please indicate currency

Personal Details

Name MOHAMED YASSIN BINROSLAN

Family Name ROSLAN

Identification/Passport No. 940329145521 Date of Birth 29-MAR-1994 (e.g. 01-JAN-1999)

Sex Male Ethnicity MALAY

Citizenship MALAYSIAN Religion ISLAM

House Tel No. +60 3 41072029 Mobile Tel No. +60 0173584449

E-Mail Address [email protected]

Permanent Address NO9 JALAN AU4/6 TAMAN KERAMAT TENGAH 54200 KUALA LUMPUR

Correspondence Address(if different from above)

Qualifications

Level Institution / Location Qualification ObtainedCGPA /Grade

Year(Completed)

High School / Secondary

School

SEKOLAH MENENGAH

SAINS REMBAU

SIJIL PELAJARAN MALAYSIA

(TRIAL)

1A+ 4A 1A-

2B+ 1B2011

Pre-University Diploma

First Degree(latest semester)

Others

Co-Curricular Activities

Most recent activities in which you assumed leadership position(s)

Year Position Held Society / Club / Activities Institution

2010 SECRETARYBADAN DAKWAH AGAMA DAN

ROHANISM SAINS REMBAU

2011 PATROL LEADER SCOUTS SM SAINS REMBAU

2011 TREASURER KOPERASI SEKOLAH SM SAINS REMBAU

Sports activities represented

Year Sport Activity Level Represented Institution

2011Tan Sri Hamzah CupCricket Tournament

School SM SAINS REMBAU


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School School

Academic Awards & Commendations

Year Awards/Commendations Received

2011 KILAUAN MUTIARA

2011 DISTINCTION ICAS 2011

2010 ANUGERAH AKADEMIK TERBILANG

Family Particulars

Please fill in the details of your immediate family members/guardian(s)

Name Relationship Occupation / StatusMaybank PF

(if employee)Monthly Gross

Income *

ROSLAN BIN KARIM Father PENSIONER RM1000-RAHMAH BINTI HAJIMOHAMED Father ACCOUNTANT RM 3400- Father

Father Father Father Father Father

* Please indicate currency

Monetary Aid from Other OrganisationsPlease state all monetary aid previously received & currently receiving

Organisation Amount *Form of Assistance(Scholarship/Loan)

Period of Aid(yyyy yyyy)


Guarantors Details

Guarantor 1

Name ROSLAN BIN KARIM

Identification/Passport No. 510907045187 Date of Birth 07 SEP 1951 (e.g. 01-JAN-1999)

Relationship FATHER Citizenship MALAYSIAN

Occupation PENSIONER Monthly Gross Income*

-1000.00

House Tel No. +60 3 410720209 Mobile Tel No. E-Mail Address Permanent Address NO9 JALAN AU4/6 TAMAN KERAMAT TENGAH 54200 KUALA LUMPUR


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Guarantor 2

Name RAHMAH BINTI HAJI MOHAMED

Identification/Passport No. 560825085834 Date of Birth 25 AUG 1956 (e.g. 01-JAN-1999)

Relationship MOTHER Citizenship MALAYSIAN

Occupation ACCOUNTANT Monthly Gross Income*

-3400.00

House Tel No. +60 3 41072029 Mobile Tel No. +60 0132086065

E-Mail Address Permanent Address NO9 JALAN AU4/6 TAMAN KERAMAT TENGAH 54200 KUALA LUMPUR


Declaration

Have you ever been convicted by a Court of Law of any country? NoIf yes, please give brief details:Are you suffering / have suffered from any medical conditions (mental and physical) which requires regular orprolonged medical treatment? NoIf yes, please give full details:I hereby declare that the information provided in this application form is true and correct. I authorise Maybank toobtain official records, if necessary, from any educational institution attended by me. I understand that any provisionof inaccurate or false information or omission of information will render this application invalid and that, if admitted onthe basis of such information, I can be required to withdraw from the scholarship.

By clicking this checkbox, I have read and agree to the above declaration. I also understand that I will berequired to sign a copy of my application form if I am shortlisted for interview with Maybank.

____________________________Signature of ApplicantDate: _______________________

Checklist of Document Submitted

Recent Passport-size photo

Identification Card or Passport (front & back)

Applicant

Both parents and/or guardian(s)

Both guarantors

Scanned copies of academic certificates & transcripts (SPM / O-Levels / UEC / STPM / A-Levels / SAM / CPU /Matriculation / Diploma / IB / etc.) *

Testimonial and recommendation letter from school/university *Leaving school certificate / Sijil berhenti sekolah

Co-curricular certificate(s), etc. *Latest Income Tax Return, EA Form, Payslip of Parents/Guardian(s) and Siblings (if any) *

University acceptance letter *

*Note : Applicants need to produce original copies during the Scholarship interview should he or she been shortlisted

MaybankScholarshipForm2012-01-20

Documents

Transcript of MaybankScholarshipForm2012-01-20