COLLEGE OF ALICE & PETER TAN CAPT GRANT SCHEME AY13/14

Rationale As a result of the generous gift from our benefactors, the College is able to expand its financial aid to students; this is in line with the Universitys vision that no student who qualifies for admission to the Residential Colleges and who would benefit from the opportunity to live and learn at University Town should be denied that opportunity. The CAPT Grants aim to complement existing financial aid schemes offered by the University for residential living. The existing College Grant scheme which was inaugurated in AY12/13 will be subsumed under the CAPT Grant Scheme. The College will continue to accept gifts from donors who wish to support students who are in need of financial aid. Structure Grant support will be given according to the level of need assessed, based on household per capita income (PCI) and/or verifiable extenuating circumstances. During the semester, the College may also extend urgent assistance based on such needs, at its discretion. In general, the two levels of support provided, based on assessed need are: $2,200 ($1,100 per semester) and $800 ($400 per semester) On a case-by-case basis, the College will also consider supporting the costs of accommodation (room only) in full. All Grants are disbursed on a semestral basis and commuted directly towards the cost of accommodation in the College. Important Information Freshmen - incoming freshmen who are have received and accepted an offer from the College should apply directly to the College for these Grants. Returning students - current members of the College can apply at any time before the closing date given below. Applicants must be in good academic standing with the University and the College. Senior students who have applied for retention are encouraged to apply for the Grants while awaiting the outcome of the retention exercise. Recipients of UTown Scholarships or Bursaries valued at $5,000 and above will not be eligible for these Grants. Students receiving UTown Residential Program Bursaries or other financial aid packages which do not cover the full cost of residence may apply. All applicants will need to submit the relevant documents for means testing. The College adheres to NUS guidelines for means testing, with the additional provision for assistance based on verifiable extenuating circumstances. Students who are already receiving other bursaries/scholarships or financial aid will be responsible to ascertain from their sponsors that they are permitted to receive these Grants in addition to their existing awards or financial aid. Instructions for submitting an application Please read the following instructions carefully before filling out and submitting your application: 1) This application form is for students who are applying for a CAPT Grant in AY2013/2014 (Semester 1 and/or Semester 2). 2) All applications are reviewed by the College administration, and provision of the Grant will be needs-based and means-tested. Applicants may be invited for an interview. 3) Students who are already receiving another bursary/scholarship/other form of financial aid should check with their bursary/scholarship/financial aid provider for eligibility to receive this Grant before sending in their application. 4) Please fill out all fields legibly.
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5) This application form must be accompanied by (I) Income tax statement or pay slips of immediate family members; and (II) Supporting documents for scholarships or any other existing financial aid (if applicable). (III) Other relevant documents supporting extenuating circumstances described in the application 6) Failure to furnish supporting documentation will render your application invalid. Supplying false information will lead to withdrawal of the Grant and the College may take steps to recover any monies that have been disbursed. 7) All information / documents submitted to the College will be kept confidential.

8) Please submit your completed application form via e-mail to capt@nus.edu.sg, or by hand (during office hours) to
the College Office at 8 College Avenue East, #B1-50. Any enquiries should be directed to capt@nus.edu.sg.

9) Please note the following closing dates for applications for AY13/14: a. b. Returning seniors (currently in Year 1) c. Incoming freshmen d. New seniors
Returning seniors (Year 2 and above) 22 April 2013 (students will be informed of the outcome together with the results of the seniors retention exercise) 22 April 2013 15 May 2013 15 May 2013

If you miss these deadlines, you are advised to check the website for updates, as more than one application window may be open, depending on response and availability.

COLLEGE OF ALICE & PETER TAN APPLICATION FOR CAPT GRANTS, AY2013/14
For Official Use Only Application Reference: APPROVED / REJECTED / KIV Remarks: _______________________________________________________________________

(A) PARTICULARS OF APPLICANT (STUDENT) Name: Matric No.: NRIC No.: Date of Birth: Citizenship Singapore Citizen Singapore PR Non Singapore Citizen Nationality: ________________ Marital Status: _________________ Race: Age: __________ Sex Male Female Home Faculty: _____________ Year of Study: _____________ CAP (last semester): ________ Home Tel No.: ______________________________ Mobile Tel No.: ______________________________ Email: ______________________________________________ NUS email address Home Address: Singapore( ) Type of Housing: HDB Private Others, please specify: _______________________________ Status: Owned Rented

Are you a Scholarship/Bursary Holder? Name of Scholarship/Bursary

No Yes (If yes, please furnish details below.) Duration (in Months) Value of Award Per Year
(e.g. Tuition fee+ $2,000 allowance)

Date Received (MM/YYYY)

Are you receiving any financial aid? No Yes (If yes, please furnish details below.) Name/Source of Financial Assistance Date Received (MM/YYYY) Duration (in Months) Value of Aid (in SGD)

(B) PARTICULARS OF FAMILY MEMBERS (REFER TO ANNEX A)

(C) DECLARATION I declare that the information provided by me in this application is true and correct to the best of my knowledge and belief, and I furnish the information knowing that I may be liable to prosecution if I have stated any information, which I know to be false, or do not believe to be true. I will inform College of Alice & Peter Tan of any subsequent changes in the information applied in this application, such as the change of address, monthly income, etc. (Tick if this applies) I am a holder of a bursary/scholarship/other form of financial aid and declare that I have confirmed with my sponsoring agency that they have no objections to my receiving a College grant.

Signature of Applicant: Name: ________________________ Date: _________________________

ANNEX A (B) PARTICULARS OF FAMILY MEMBERS Monthly Gross Income ($)1 Relationship With Applicant Identification No.
Eg. Passport, NRIC.

Name of Family Member in the Household

Staying with applicant? Yes No

For Official Use Only Type of Member2

Age

Occupation

(please attach supporting documents)

Sample

Applicant

For Official Use Only

TOTAL3 INCOME PER CAPITA

$ __________ $ ___________

______ Headcount

* Please state (verifiable) extenuating circumstances in the family, if any: ____________________________________________________________ _____________________________________________________________________________________________________________________ _____________________________________________________________________________________________________________________
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Refers to gross monthly income of applicant and immediate family member(s), before deduction of CPF, rental income etc. This includes all sources of income, including rental, interest. Documents for verification income tax statement, pay slip, for those without pay slip or income tax statement, and other supporting documents where applicable. 2 I Immediate family member N Family member not eligible for computation in headcount. 3 Total headcount and monthly gross income should exclude family members not eligible for computation in headcount.
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FOR OFFICIAL USE ONLY NAME: VERIFIED BY ADMIN STAFF I have checked that the means test has been applied appropriately based on the Guidelines on Means Testing Framework. Recommendation: _________________________________________________________________________ ________________________________________________________________________________________

Signature

Name & Designation

Date

RECOMMENDATION BY CAPT GRANT COMMITTEE Supported Not Supported

(if supported), I recommend that approval be granted for the above applicant to receive a subsidy rate of _____________ stated above with effect from ___________________________. Recommendation: _________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________

Signature Signature

Name & Designation Name & Designation

Date Date

APPROVAL BY MASTER Approved Not Approved

Reasons: _______________________________________________________________________________ ________________________________________________________________________________________ ________________________________________________________________________________________

Signature

Name & Designation

Date