alg Ay ALLITHYPERMARKET ALL IT STUDENT LAPTOP SPONSORSHIP APPLICATION FORM Please read the following instructions carefully before filling the Application Form. 1. Are you a Malaysian Citizen below 25 years of age as on 1st January 2018? 2. Ara you presently enrolled as a full-time tertiary student (Diploma, Pre-U, Bacholor Degree) at any local University/Collage? *This sponsorship is net applicable to Post Grad students 3, Is your household gross income combined less than RMSO00/mth? 4, You are currently not bonded to or in receipt of any scholarship rewards from other educational institutions or organisations? (Student with PTPTN loan is permitted to apply) all your answers above are "Yes", you are eligible to apply for this sponsorship. Application Instructions 1. Applicants should complete all parts of this form. State “N/A” for sections not applicable to you. Copies of required documents (non-returnable) should be attached to the filled form. 2. 3, Where space is insufficient, please continue in separate sheet and attach together. 4. Incomplete or late applications will not be accepted. Closing date is 30 June 2018, 5. Attach your attachments in the following order ves NO ves No YES No YES No No | List of Documents Tick 1 Copy of NRIC/MyKad/Birth Cert Copy of SPM/STPM Cert or equivalent Copy of recent undergraduate studies exam results, applicable 6. Submit application form to: ‘Student Laptop Sponsors! ALLIT Hypermarket Sdn Bhd, 12, Jalan BK1/13, Taman Perindustrian Bandar Kinrara, 47100, Puchong, Selangor Darul Ehsan. For further enquiries, please email to sponsorship@allitcom.my Closing PERT CP SE Lc Ret ALLIT STUDENT LAPTOP SPONSORSHIP Application Form Copy of your parents’ recent pay-slips, latest Income Tax Statement, EA form or any other proof of income Page 1 of 5‘Section A - Personal Information Name (as per! Date ofBirth = IN Gender (M/F) Rac Address Recent Photograph TelNo Mobile No: Email Addrose Section B - Academic Qualifications Please enclose copies of academic results ‘Academic Qualification (circle where applicable) Coe Month & Year of Completion/ Expected Completion SPM/O-levels, Name & Address School STPM/UECIA.lovele/ Matriculation Name & Address of Schoo! Other, pleas Section C - Current Programme Enrolled. Colleges/Universitios/Institutions: Programme: Eni Section D - Other Qualificati - Duration of yeers(estimated) ond currently has completed yearsimonths Activities in School / College / University Position Year ALLIT STUDENT LAPTOP SPONSORSHIP Application Form Page 2 of 5Prizes/Awards/Recognition as academic & Prizes/Trophies/Medals for sports or competition Year ‘Section E - Work Experience (if any) Name of Employer Designation Period ‘Section F - Family Background Please attach a copy of Parent's/Guerdian’s recent pay-slip/income tax stetement, For retirees, please submit last drawn selary slip. Father Guardian ‘Mother / Guardian Name Name & Address of Employer Additional Income per month (RM) ‘Total Income per month (RM) FilLup below if your parents/guardian are self-employed: If Yes, is the business wholly owned? YES NO. Nature of businese: Length of establishment of businese__ years _monthe ALLIT STUDENT LAPTOP SPONSORSHIP Application Form page 3 of 5Siblings Details Siblings ‘who are working Gender (M/F) Occupation Name of Company Monthly Income (RMI Siblings who are currently pursuing their education Name Gender (M/F) Name of School / College / University Other Dependents ‘Age | Gender (M/F) Relationship Annual Gross Income of Parents/Guardian| (Last yeor) Father (RM) ‘Mother (RM) Guardian (RM) Total (RM) Employment Business Rental Others Total Family Expenditure ‘Type of Expenditure Monthly (RM) Yearly (RM) House Installments / Rental tricity / Water Telephone / Mobile alels Veen Repeyrvent [1] Hive Purchase Loan Personal toan [otters Transportation Cost CO Petro! setoot aus [others ALLIT STUDENT LAPTOP SPONSORSH NP Application Form Page 4 of 5Type of Expenditure Monthly (RM) ‘Yearly (RM) Education Expenses for person(s) Medical Expenses Insurance Premium Food / Living Expenses 10] Others: SOG Total Expenditure ‘Section G - Personal Statement Please tell us in your own words more about yourself and why do you need the Laptop & Cash Voucher? Your personal statement should be NOT more than 200 words. Section J = Declaration by Applicant | deciare that the information contained in this application form and in the attached documents are true and accurate to the best of my knowledge at this time. further acknowledge that ALLIT HYPERMARKET reserves the right to vary or reverse ary decision made ‘on the basis of incorrect or incomplete information, the sponsorship will be terminated immediately and | will be liab’e to re-pay ALL IT HYPERMARKET tho value of sponsorship received. | acknowledge that ALL IT HYPERMARKET reserves the right to seek fram other relevant bodies verification as to the standing of my claimed qualifications. Ihereby warrent that | have obtained all necessary consent from the thicd party where | have provided their personal information as part of my application such as information relating 10 my parents. Ihereby agree, consent end ellow ALLITHYPERMARKET to share all my perscnal information conteined herein with any and/or all of ‘this CSR Campaign's Spansors - Acer Malaysia for marketing purposes. Lalso promised will use the Laptop that I've obtained from this CSR Campaign for study purposes and not to resell to make profit. Applicent’s Signature ‘Thank you for your application. ALLIT STUDENT LAPTOP SPONSORSHIP Application Form ——————________________ page sof 5