Please affix a recent

OCBC PUBLIC SCHOLARSHIP passport size

photograph here
APPLICATION FORM

PERSONAL INFORMATION

Full Name (As per IC) Telephone/ Mobile No.

(012-12345678)

Gender (Female/Male) Marital Status

(Single/Married)

Permanent Address

Date of Birth Place of Birth

(DD/MM/YY)

Nationality Identity Card No.

(xxxxxx-xx-xxxx)

Do you have any physical If yes, please specify:

disability or handicap? Yes No

FINANCIAL POSITION

FATHER

Full Name (As per IC) Age

Occupation Name of Employer

MOTHER

Full Name (As per IC) Age

Occupation Name of Employer

FAMILY INCOME
Please indicate below the amount of income earned by each member of your family. Family members include father, mother, brothers and sisters.

Total Monthly Contribution to

Full Name Relationship Occupation Income Family
(RM) (RM)

What is the estimated monthly expenditure of your family? RM:

Please list below all family dependents

Full Name Relationship Age

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Do any of your family members own properties or have a share in any business? If yes, please specify.

Please state the types of bursary, scholarships or financial grants and their values which you are currently in receipt, if any.

1.
2.
3.
4.
5.
6.

ACADEMIC BACKGROUND
List below, in reverse chronological order, each educational institution you have attended and the highest level of examination passed. You must enclose
photocopies of all academic transcripts.

Dates (Year)
Educational Institution Exam Passes / Grades Obtained
(Most Recent) From To

List below any scholastic awards and honours you have obtained in schools and/or universities.

Award / Honour Year

LEADERSHIP ACTIVITIES
List below all leadership activities in which you have actively participated (Academic / Sports / Community). You may also include other relevant and
important activities if any.

Types of Activities Position and Responsibilities Year

HOBBIES AND INTERESTS

List below your hobbies, interests and other social activities. You may also include information about other relevant and important activities if any.

1.
2.
3.
4.
5.

UNIVERSITY ADMISSION
List below your intended course of studies and the universities you have applied to (in order of preference).

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 Name of University Field of Study

First Choice

Second Choice

Third Choice

REFERENCE
List below the names and information of TWO referees who are not related to you. One of the referees must be competent to share on your previous
academic achievements.

Name Telephone Occupation / Place of Work

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OTHER INFORMATION

Why are you interested in getting an OCBC Scholarship?

What are your career goals?

DECLARATION
I understand that the personal data indicated in this Form is necessary for the Bank to process my scholarship application and I have voluntarily
provided my personal data including my sensitive personal data to the Bank including their appointed personnel, representatives, and/or their
respective employees.
I authorise investigation of all statements and attachments contained in my application for an OCBC scholarship. I fully understand that a
misrepresentation or omission of facts will be sufficient cause for cancellation of consideration or withdrawal of the said scholarship if my application
is successful.

Insert your e-signature here

Name: Date

Note:
Please read the declaration and acknowledge before signing.

January 2025

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OCBC PUBLIC SCHOLARSHIP
APPLICATION FORM

Prepare an essay of 800 words on the topic below:

Have you been in leadership positions in school/university? If yes, what are the biggest challenges you have faced and what have you learned from it?

January 2025

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OCBC PUBLIC SCHOLARSHIP - DATA PRIVACY CONSENT FORM
Declarations and Consent Clauses
(a) Each of us have voluntarily provided our personal data, including sensitive personal data (as defined under the Personal Data Protection Act 2010), to
OCBC Bank (Malaysia) Berhad (the “Bank”) and consent to the Bank processing our personal data in connection with the application for scholarship by the
Bank and in accordance with the Bank’s privacy policy which is accessible at the Bank’s website (https://www.ocbc.com.my/group/security-privacy). If we
do not provide any data required in this form, the Bank may not be able to proceed with the scholarship application. We have read the Bank’s Privacy
Policy made available to me and confirm that we have been notified of and agree with the following matters via the Bank’s privacy policy (i) that the Bank
may collect our personal data directly from us or from third party sources; (ii) purpose for which our personal data is collected; (iii) our right to access our
personal data and correct it; (iv) the class of third parties (including those named in sub-clause 3(c) below) to whom the Bank may disclose our personal
data; (v) the choices and means for limiting the processing of our personal data; (vi) whether the personal data requested is obligatory or voluntary, and if
obligatory, the consequences for not providing such data; (vii) to update our personal data as soon as there are changes; and (viii) the Bank’s contact
details if we wish to make inquiries or give feedback.

(b) Each of us agree that our personal data (“Information”) will be disclosed to persons or bodies to whom the Bank is legally required or permitted by law
to disclose or is approved in writing by Bank Negara Malaysia to disclose or is now hereafter permitted in writing by us to disclose.

(c) Without limiting sub-clause 3(b) above, we expressly consent to the disclosure of the Information to the parties and for the purposes set out in the table
below:

Parties to Whom Information can be Disclosed Purposes/Circumstances for Disclosure of Information

1 The Bank’s data processors and service providers, both For the performance of services for the Bank.
within and outside Malaysia;

2 Regulatory authorities/law enforcement bodies both For compliance with law and regulations.
within and outside Malaysia;

3 Lawyers, accountants, insurers, insurance brokers, For professional advice and consultation from professionals engaged by Bank.
specialists in fraud, information technology and other
professionals/consultants/ specialists to render
professional or specialist services to the Bank in relation
to any matter of law, accountancy, insurance or any other
matters requiring professional or specialist knowledge or
advice;

4 Our authorized agents, executor, administrator or legal For purpose of managing our affairs.
representative; and

5 The Bank’s assignees or acquirers, potential assignees or For reorganization including disposal of the whole or any part of the Bank’s business.
acquirers and successors-in-title.

6 Education institution with which the applicant intends to For payment and related matters.
pursue studies/course/education.

d) Each of us irrevocably consent to and authorize the Bank to conduct credit checks and verify information given by us with any party (including without
limitation with any credit bureau, organization or corporation set up for the purposes of collecting and providing credit or other information) and consent
to the relevant credit reporting agencies with whom the Bank conducts credit checks to disclose our credit report/information to the Bank for the purpose
of the application for scholarship.

(e) Each of us shall indemnify the Bank for any breach of these Declarations by us which renders the Bank liable for any fines, penalties, losses, damages,
costs or expenses.

For Applicant:

____________________________ _________________
Signature Date
Full Name of Applicant:

For Parent/Guardian (1): For Parent/Guardian (2):

____________________________ _________________ ____________________________ _________________

Signature Date Signature Date
Full Name of Parent/Guardian (1): Full Name of Parent/Guardian (2):
January 2025

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OCBC PUBLIC SCHOLARSHIP
CHECKLIST OF REQUIRED DOCUMENTS

Full Name

Email

Contact No.

IMPORTANT1. Please attach this checklist with all required documents listed below.2. All documents should be emailed to OCBC Public Scholarship Secretariat ([email protected]).3. Applications w

Please tick (√) if documents are available.

Tick (√) Required documents for all applicants: Reason(s) if unavailable.

Indicate date of availability

OCBC Public Scholarship Application Form - First tab: Part 1 - Application Form
(Complete with e-signature)

Passport size photograph (Blue background)

Copy of NRIC (Front & Back)

Curriculum Vitae
(Including details on extra-curriculum activities, leadership and achievements)

Copy of SPM / UEC results

Copy of STPM / GCE A-Level / Matriculation / Foundation / Diploma Results

Copy of MUET results (If available)

Copy of Year 1 academic transcript

(For existing university students only)
Copy of relevant certificates of achievements, appreciations,
appointments and/or participations in schools and/or university

Copy of parents / guardian’s pay slip or income declaration form

Copy of Parents / Guardian Income Tax (EA Form or J Form)

Your essay of 800 words - Second Tab: Part 2 - Essay

Data Privacy Consent Form - Third Tab : Part 3 - PDPA Declaration

Note:

All documents above must be certified true copy by either one of the following:-
1. Government School Principal
2. Community Leader
3. Government Servant (Management / Professional)

January 2025

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