MOE Overseas Student Attachment Programme 2014 A Name Citizenship Email address B PERSONAL PARTICULARS : : : Sex : M / F CT Group :

ACADEMIC RECORD

Details of GCE O-level results / Sec 4 IP results L1R5 (for O-level students) or MSG (for IP students): No. 1 2 3 4 5 Subjects taken in JC1 : Subject Grade No. 6 7 8 9 10 Subject Grade

CO-CURRICULAR ACTIVITIES (Please write/type neatly and indicate year of involvement) CCA grade: ________________

1.

Please list your CCA involvements, including positions of responsibility and achievements.

2.

Please give details of science research projects or attachments you have undertaken (include period of work and title of project).

MOE Overseas Student Attachment Programme 2014 3. Indicate if you have presented science research projects at science fairs (include the name of the science fair, the project title, the year of participation and any awards won).

4.

State any other science competition you have participated in, and any awards you received.

D 1.

CHOICE OF PROGRAMMES Indicate the overseas student attachment programme which you would like to be considered for in order of your preference: First Choice: Second Choice: Third Choice:

E 1.

ADDITIONAL INFORMATION Indicate a field / subfield of science or mathematics which you are interested in and why it interests you.

2.

What do you hope to achieve through participating in the programme(s) that you have selected?