Application for Admission (Undergraduate Programme)

SIM University
(UniSIM)
Please paste a recent
461 Clementi Road Singapore 599491
colour passport-sized
Tel: 6248 9777 Fax: 6469 9312 www.unisim.edu.sg photograph

(Please indicate your

name & NRIC No. on
the reverse of the photo)

1 Choice of Programme

Choice Programme Title (eg. BSc Business) Intake (month/year)

st
1
2nd

2 Personal Details

NRIC/FIN No: Passport No:

(for foreigners without FIN No.)

Title*: Mr / Ms / Mrs / Mdm /Dr

(Delete where appropriate)

Full Name:
(As it appears in your NRIC/Passport. Please underline surname. Full name will be used for student registration, degree certificates, transcripts and all correspondences)

Home Address:

Postal Code

Home Tel. No: 6 Handphone No:

E-mail Address: Preferred Mailing Address: Home Office

Marital Status: Single Married Others Gender: Male Female

Date of Birth: / / Age:

dd mm yyyy

Nationality: Singaporean Malaysian Others (specify):

Residency Status: Permanent Resident Employment Pass/ Others (specify):

(for non-Singapore Citizens only)
Work Permit

Race: Chinese Malay Indian Others (specify):

Completed Currently Serving

National Service (NS): Regular Exempted Not Applicable
full-time NS full-time NS

National Service Period from ___________to__________ (ORD)

Length of full-time National Service served: ______years______months (eg. 2 years)
(as at intake start date)

Length of full-time National Service required: ______years______months

For Regulars, please only indicate the NS required. Indicate the rest of your working experience under Present Employment.

3 Past Enrolment as an UniSIM/SIM-OUC Student

Have you ever registered as a student of UniSIM or SIM-OUC?

Yes. Year of Admission: ____________ No

Year 2008
 4 Present Employment Details

Company Name:

Company Address: Postal Code

General Tel No: 6 DID/Ext: Fax: 6

Industry Code: 0 2 0 -
Refer to Code Table

Company Type: Government Ministry Statutory Board Professional Body

Public Listed Private Others (please specify)

Name of Division/Department/Section: Job Function Code:

Refer to Code Table

Current Designation: Current Designation level: 0 9 0 -

Refer to Code Table

No. of years/months in this company: From: / Full-time Part-time

mm yy

Gross Annual Income:

5 Past Employment Records

In chronological sequence, starting with your most recent past position:

Period (mm/yyyy) *Full-time

No. of (FT)
Name of Company Designation
From To Years/Months Part-time
(PT)
1) FT PT

2) FT PT

3) FT PT

4) FT PT

5) FT PT

6) FT PT
* Delete where appropriate

6 Summary of Working Experience

a) Total number of years/months of Full-time working experience (excluding National Service) years months.
(note: You must attach a letter of full-time employment with this application)

b) Total number of years/months of Part-time working experience (excluding National Service) years months.

c) Total number of years/months of relevant working experience applicable to Programme applied (1st Choice) years months.

Year 2008
7 Educational Qualification Details
Taken at
Qualification Level Name of Qualification & Awarding Institution Country Period of Study Mode of Study SIM/SIM-OUC /
UniSIM
Master’s Fr: Part-time Yes
Awarding Institution Country mm/yyyy

To: Full-time No
Qualification Title mm/yyyy

Taken at
Qualification Level Name of Qualification & Awarding Institution Country Period of Study Mode of Study
SIM/SIM-OUC
Bachelor’s Fr: Part-time Yes
Awarding Institution Country mm/yyyy

To: Full-time No
Qualification Title mm/yyyy

Taken at
Qualification Level Name of Qualification & Awarding Institution Country Period of Study Mode of Study
SIM/SIM-OUC
Diploma Fr: Part-time Yes
Awarding Institution Country mm/yyyy

To: Full-time No
Qualification Title mm/yyyy

Taken at
Qualification Level Name of Qualification & Awarding Institution Country Period of Study Mode of Study
SIM/SIM-OUC
Certificate Fr: Part-time Yes
Awarding Institution Country mm/yyyy

To: Full-time No
Qualification Title mm/yyyy

Qualification Level Name of Qualification & Awarding Institution Country Period of Study Mode of Study
Other Qualifications ++ Fr: Part-time
Awarding Institution Country mm/yyyy

To: Full-time
Qualification Title mm/yyyy

“A” Level Qualification

GCE ‘A’ Level (Singapore-Cambridge) Number of ‘A’ level passes Year of Award:
Number of ‘AO’ level passes
Other GCE ‘A’ level equivalent (e.g., STPM, HSC, IB) No. of passes ____________ Year of Award:

(please specify qualification title, awarding institution and country of qualification)

“O” Level Qualification

GCE ‘O’ Level (Singapore-Cambridge) Number of ‘O’ level passes Year of Award:

Other GCE ‘O’ level equivalent (e.g., SPM) No. of passes ____________ Year of Award:

(please specify qualification title, awarding institution and country of qualification)

Grading of English Language (as 1st Language) :

Indicate scores for Test of English as a Foreign Language (TOEFL) or International English Language Testing System (IELTS) if you have taken them
TOEFL TOEFL; Year of award (Total score: : Test of Written English score ____________ )

IELTS IELTS; Year of award (Total score: : Score of Sub-Test 1: /2: /3: /4: )
I will be taking the TOEFL / IELTS* on _______________________ (date) Results will be released on ____________________.
I agree to send a copy of the results to SIM University upon request.

Other programmes that you are currently pursuing (including SIM and UniSIM programmes)
Programme(s) Institution Date of Final Examination

2
( Please submit certified copies of all transcripts/result slip available todate)

++ If you have more qualifications under this category, please provide on a separate sheet of paper.
* Delete where appropriate

Year 2008
8 To be Completed by Company (applicable to those under company sponsorship and Corporate Member)

a) Company Sponsorship

Company is sponsoring the applicant for:

(i) course fee Yes No

(ii) membership fee Yes No

Company Certification

We certify that all statements made on this application are true and complete to the best of our knowledge.

Name and Designation of Authorised Company Official Contact No.

Signature & Date Company Stamp

b) Company is a SIM Corporate Member Yes No

Please enclose a letter duly signed certifying the staff taking the programme is under employment with the company and provide the SIM
Corporate Membership number. If there is no verification, the staff taking the programme will be invoiced for membership fee as a SIM
Student Member.

Code Table
Industry Code
Agricultural, Forestry & Fishing 101 Manufacturing Transport, Storage & Communications
Transport Equipment (Shipbuilding/Repairing Storage and Warehousing 702
Mining & Quarrying 201 Marine Engineering/Offshore Rigs, Motor Travel Agencies 703
Vehicles, Motor Cycles, Bicycles & Aircrafts) 316
Manufacturing Instrumentation Equipment, Photographic Finance Insurance Real Estate and Business Services
Food, Beverage, Tobacco 301 & Optical Goods 317 Banking and Financial Institutions 801
Textiles, Wearing Apparel 302 Other Manufacturing Industries 399 Insurance 802
Leather Products, Leather Apparel 303 Real Estate, Housing Development and Investment 803
Timber & other Wood Products, Furniture 304 Electricity, Gas & Water Legal Services and Consultancy 804
Paper Products 305 Gas Manufacture and Distribution 401 Accounting, Auditing/Data Processing Services 805
Printing and Publishing 306 Engineer, Architectural/Technical Services 806
Industrial Chemicals, Gases 307 Construction Advertising Services/Employment Agencies 807
Chemical Products 308 Building Construction, Electrical Wiring Medical, Dental Services 808
Petroleum Refineries and Petroleum Products 309 & Installation, Plumbing 501 Management Consultants 809
Rubber and Plastic Products 310
Earthenware and Glass Products 311 Commerce Public and Private Bodies
Cement and Concrete Products 312 Wholesale and Retail Trade Government Ministries 901
Iron and Steel, Tin Smelting 313 (including Import and Export) 601 Statutory Boards 902
Fabricated Metal Products, Machinery 314 Restaurants and Hotels 602 Associations 903
Electrical and Electronic Products Holding companies 603 Professional Bodies 904
(including computers) 315 Educational Bodies 905
Transport, Storage & Communications Armed Forces 906
Land/Sea/Air Transport 701 Others 999

Current Designation Level

Top Management 1 Junior Management 4 Sole Proprietor 7
Senior Management 2 Non-Managerial Professional/Technical Exec. 5 Student 8
Middle Management 3 Non-Executive Staff 6

Job Function
Admin/Secretarial ADM1 Mass Communication MC1 Property & Estate Management PPT1
Advertising and Promotion ADV1 Purchasing PUR1
General Management (CEO, MD, EXD) CEO1 Mechanical Engineering MEC1 Quality Control QTY1
Civil Engineering CIV1 Manufacturing MFG1 Research and Development RD1
Corporate Planning COR1 Management Information Systems MIS1 Religious Services REG1
Board Membership (Chairman, BDIR) DIR1 Marketing and Sales MKT1 Retiree RET1
Physical Distribution/Warehousing DIS1 Medical Services NUR1 Security Services SEC1
Electrical/Electronic Engineering ELE1 Production PDN1 Teaching (In school) TEA1
Plant and Industrial Engineering ENG1 Project Management PM1 Teaching (others) TEA2
Finance and Accounting FA1 Transportation Service TRA1
Hospitality Services HOS1 Unemployed UNEM
HRM/HRD (Personal/Training) HR1 Others ZZZ
Legal Services LG1
Maintenance and Services MAN1
Year 2008
Important Instructions
a) An application fee of S$42.80 (inclusive of 7% GST) is charged for each application. Each applicant should only submit one application form.

b) You may apply for a maximum of two programmes, but you would only be admitted to one programme.

c) All applicants (including Citizens and Permanent Residents of Singapore) must submit a copy of personal identification (e.g., Identity Card, Foreign ID Card,
Passport). Non-Singaporean must also submit a copy of valid work-permit/employment pass/dependent pass.

d) Certificates and detailed result transcripts of academic qualifications must be attached to this application form.

e) If you have attained academic qualification beyond GCE ‘A’ level, i.e., Diploma, Advanced/Higher Diploma or a Degree, you are eligible to be considered for
Credit Exemption. See Section 11 of this application form.

f) All applications with incomplete information and/or not accompanied by copies of supporting documents, photograph and application fee will NOT be
considered.

g) All educational certificates, result transcripts and identification documents (eg. NRIC) must be certified by UniSIM. Please bring your original
documents and photocopies for verification at SIM University, 461 Clementi Road, Student Recruitment Department, Level 2. Educational certificates
and transcripts may also be certified true copies by the awarding institutions (eg. Polytechnic).

h) Kindly note that you will be considered for admission to UniSIM if you meet our minimum eligibility criteria. UniSIM reserves the right to accept or reject an
application.

i) For more details, please refer to our website http://www.unisim.edu.sg, under the “Admissions” page.

9 How did you first learn about UniSIM? Please tick
ONE box only:

Bus Advertisements LianHe ZaoBao

Magazines MRT Advertisements
Advertisements My Paper Business Times
Radio Advertisements The Straits Times
TODAY TV Advertisements

Career Fair/Postgraduate Fair/Other Local Exhibitions Overseas Exhibition

Fairs / Seminars
UniSIM/SIM Open House Talks / Seminars

Direct Mailers Mailers through MOE Schools

Mailers
Mailers through tertiary institutions

Internet NTUC/SAFRA/HomeTeamNS/at-sunrice Website

On-Line
UniSIM/SIM Website

SIM Directory Today’s Manager

Publications
Polytechnic Publications

Word of Mouth Friends/Family Members UniSIM/SIM Graduates

Colleagues / Employers UniSIM/SIM Students

10 Is UniSIM your first choice? You may select more than one.

a) If Yes, please tick
the reason(s) for your choice:

Accessibility Credible lecturers Facilities & resources
Flexible & independent learning Local university Programme offering
Quality degree Reputation of UniSIM Recognition by employers
Recommendation from friends/colleagues/family members University for adult learners
Others (Specify):

b) If No, why? Please tick
the reason(s):

I have also applied for admission with other local universities
I have also applied for admission with other educational institutions
I prefer a degree awarded by an overseas university
UniSIM does not have my first choice of study
Others (Specify):

Year 2008
11 Credit Exemption

If you have attained academic qualification beyond GCE ‘A’ level, i.e., Diploma, Advanced/Higher Diploma or a Degree, you are eligible to be
considered for Credit Exemption. Please tick
one of the following:

 Yes, I wish to be considered for credit exemptions.

 No, I do not wish to be considered for credit exemption.

PLEASE NOTE THAT IF YOU DO NOT APPLY FOR CREDIT EXEMPTION NOW, YOU CANNOT APPLY FOR IT AT A LATER
DATE.

In order for UniSIM to assess your previous qualification for Credit Exemption, please attach the programme syllabus and a copy of your
academic transcript. Applications with incomplete information will NOT be considered.

If you want an indication of whether your qualification(s) is eligible for any credit exemption, please refer to our website at www.unisim.edu.sg
(under “View Credit Exemptions”). There is no application fee for the application of credit exemption; however, you have to pay a credit
exemption fee upon acceptance of the credit exemption awarded.

12 Applicant’s Checklist

Please ensure that items 1 to 3 are “Certified True Copy” and are attached to this application form. Supporting documents that are not
certified true copy will mean that your admission application will not be considered.

1) 1 copy of ALL educational qualification certificates attained (including GCE ‘O’ level qualification)

2) 1 copy of detailed result transcript

3) 1 copy of personal identification document (e.g., Identity Card, Foreign ID card, Passport, Employment Pass)

4) 1 copy of letter of employment signed by your HR/immediate supervisor, or a copy of your latest computerised payslip

5) Programme/Course syllabus of the qualification(s) which you want to be considered for Credit Exemption

6) 1 recent colour passport-sized photograph

7) Application Fee (non-refundable) made payable to: “SIM University”

8) I have asked my HR/immediate supervisor to verify the SIM Corporate Membership status (if applicable) (Section 8b)

9) For company sponsored applicants: I have asked my HR to endorse my application form (Section 8a)

13 Applicant’s Declaration

I certify that all information given by me in this application is true and correct.

I understand that any misrepresentation or omission is sufficient grounds for rejecting my application. I also understand that SIM
University reserves the right to cancel my student registration in the event of a false declaration.

I understand that SIM University may obtain or verify my academic results from the Singapore Ministry of Education or my polytechnic.

I hereby agree to abide by all regulations and procedures laid down by SIM University if I am successfully registered as its student.

I hereby declare my consent to have my particulars made available to my tutors and lecturers.

Declaration on Government Subsidy (Please tick
one of the following):

 I hereby confirm and declare that I had previously received a government-subsidised university education.

 I hereby confirm and declare that I have not previously received any subsidies from the Singapore government in relation to my
university education (whether undertaken on a full or part time basis). I acknowledge and fully understand that a false declaration
may result in the rejection of my application or termination of my studies at SIM University, and/or other legal action being taken
against me under the applicable laws.

Signature of Applicant Date

Year 2008