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Gadang Holdings Berhad (278114-K) Scholarship Application Form

This document contains a scholarship application form for Gadang Holdings Berhad. The 4-page form requests personal details of applicants, family details, education history, financial needs information, extracurricular activities, and includes a declaration and checklist. Applicants are instructed to complete the form in writing, attach supporting documents, and return the completed form to Gadang's Group Human Resource Department by the specified address and contact details.

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Kasturi Letchumanan
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116 views4 pages

Gadang Holdings Berhad (278114-K) Scholarship Application Form

This document contains a scholarship application form for Gadang Holdings Berhad. The 4-page form requests personal details of applicants, family details, education history, financial needs information, extracurricular activities, and includes a declaration and checklist. Applicants are instructed to complete the form in writing, attach supporting documents, and return the completed form to Gadang's Group Human Resource Department by the specified address and contact details.

Uploaded by

Kasturi Letchumanan
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 4

GADANG HOLDINGS BERHAD (278114-K)

SCHOLARSHIP APPLICATION FORM


INSTRUCTIONS
1. The application should be completed in writing by the applicant. An incomplete application will not be considered.
2. Please attach photocopies of certificates and testimonials. Originals to be produced during interview.
3. If necessary, due to space constraint, please attach addendum.
4. Please return completed form to:-

GROUP HUMAN RESOURCE DEPARTMENT


GADANG HOLDINGS BERHAD
Wisma Gadang, No. 52, Jalan Tago 2,
Off Jalan Persiaran Utama, Sri Damansara
52200 Kuala Lumpur
Tel: +603-6279 6288
Fax: +603-6275 2136

SECTION A

Please affix a recent passport-sized


photograph

Personal Details of Applicant

Full Name
NRIC No.

Gender

Date of Birth

Age

Correspondence Address:

Home Address (if different from correspondence address) :

Tel No. (Hse)


/Mobile
SECTION B

E-mail
address
Family Details
Father

Mother

Name

Name

Tel No. (Hse)


/Mobile

Tel No. (Hse)


/Mobile

Nationality

Nationality

Occupation

Occupation

Employer

Employer

Monthly
Gross
Income (RM)

Monthly
Gross Income
(RM)

Page 1 of 4

Name of Siblings
(Brothers & Sisters)

SECTION C

Age

Relationship

Marital
Status (Married /
Single)

Occupation & employer name (if in school, name


and address of school)

Monthly Gross Income (RM)


(if applicable)

Field of Study

Course of Study
University / College / Institute
Type of University / College /Institute

Public University (

Intake Date
(MM/YY)
Course Fee:
(for whole program)

Duration of study
(years)

Private University / College

Expected date of
Completion

If you are not a first year student, please indicate


your latest examination results
SECTION D

Secondary Education

SPM / 'O' Level or other equivalent

No. of Distinction :

_____________________________________________________

STPM / 'A' Level or other equivalent

No. of Distinction

_____________________________________________________

MUET Level or other equivalent

Results: ______________________________________

SECTION E

Other Education

Other Qualifications : (Diploma / Matriculation / Foundation)


Awarded by : (Institute / College / University)
Results (CGPA):

Page 2 of 4

SECTION F

Other Financial Assistance

1. Are you presently receiving any financial assistance from any institutions / foundations / government?

Yes (

No (

If Yes, please furnish details:


2. Do you have a Perbadanan Tabung Pendidikan Tinggi Nasional (PTPTN) loan?
SECTION G

Applied (

Approved (

No (

Extra-Curricular Activities - Please tick ()


Represented
University /
College

Sports

Uniform troop / Association / Club

SECTION H

Member

Treasurer

School

Role
Secretary

District

State

Vice President President Ad-hoc Committee

Essay

Please tell us why you need this scholarship and why you selected this course / discipline of study. You may attach addendum.

SECTION I

Checklist: Please attach copies of the following

Please tick ()

3. Copy of co-curricular activities certificates / testimonials

o
o
o

4. Copy of Offer Letter from institution of higher learning (if available)

5. Latest copy of parents salary slip

6. Latest copy of parents EPF Statement

7. Latest Income Tax Return of parents

1. Copy of I/Cs of applicant and parents


2. Copy of examination results

Page 3 of 4

Country

SECTION J

Declaration by Applicant

I agree and accept that if I am successful in my application, Gadang Holdings Berhad may use all information including my personal data strictly for purposes
relating to the Scholarship Awards, including the disclosure and transfer thereof to the selection committee and the media where necessary.

I hereby declare that the information given in this Application Form and in the documents (if any) attached hereto in support of my application is true and
correct and that I have not suppressed any material fact. I agree and accept that if any information in this Application Form (including, without limitation, my
particulars and the answers given in the questionnaire section) and in the attached documents (if any) is found to be false and/or inaccurate, my application
shall be rejected; and where the Scholarship has already been awarded to me, Gadang Holdings Berhad shall have the discretion to withdraw the same and I will
reimburse Gadang Holdings Berhad all sums that have been released for my benefit under the Scholarship Award.
I undertake to furnish Gadang Holdings Berhad with additional documents and/or information as and when required by Gadang.
Name : _____________________________________________________

NRIC No.

______________________________________________

Signature : __________________________________________________

Date:

______________________________________________

Page 4 of 4

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