Ref:
Application for Admission to a Part-Time Degree Programme Please tick as appropriate: Bachelor of Science (Honours) (Top-up) Specialisations: ☐ Forensics Computing (Part-time) ☐ Software Engineering (Part-time)
Closing Date: Before submitting this application, please ensure that you have enclosed all items under “Checklist” (7).
1.
Declaration and Authorisation
Photograph
I hereby apply for the above-mentioned programme. I declare that the information given in this form is true and complete. I understand that if falsified information is submitted, admission will be rescinded. I have read the programme prospectus and will comply with all conditions, rules and regulations of Kaplan Higher Education Institute and University of Portsmouth.
Signature
Date
2. Personal Details Title Surname
Other Names (as in NRIC or passport)
Sex
Marital Status
Age
NRIC or Passport Number
Nationality
Date/Place Of Birth
Residence address Personal Email Address Business/Organisation
Postal Code Residence Tel.
Handphone/Pager Job Tittle
3.
Education and Qualifications
Business Address
Business Tel.
Business Fax
Please send all correspondence to:
☐
Ethnic Origin
Parchment/Transcript Name
Disability/Special needs: Y/N
If yes, please specify:
Criminal convictions: Y/N
If yes, please specify:
Residence|
☐
Business
Certified copies of academic certificates and transcripts/results slips. Start Year/ End Year
School/ College
Qualification
Grade
Star Year/ End Year
School/College
Qualification
Grade
Other courses or studies undertaken
4.
English Language Proficiency
If English is not your first language, please tell us about any English language qualifications you hold and provide original or certified copies of your English language certificates with your application form. Date: IELTS: Overall Score: ____
Reading: ____
Listening: ____
Writing: ____
Speaking: ____ Date:
TOEFL: Computer-based: _________
Paper-based: ________
Internet Based: ________ Date:
Cambridge Test: Advanced Score: __________________________
Proficiency Score: ____________________ Date:
Other: Title: ___________________________________
Score: ______________________________
If you are planning to take an English language test, please give details: Test to be taken: ________________ Approximate date to be taken: ________________ Have you been educated in English: ☐
Yes
☐
No
If yes, please state no. of years: ________
5.
Career Summary
Please fill in details of your present occupation. Job Title
Since
Number of years
Organisation Brief description of duties and responsibilities
Previous Employment Record (In chronological order)
6.
Personal Statement
Year: From
To
Employer
Job Title
Year: Form
To
Employer
Job Title
Please write a statement to support your application to study this programme. Note that your application will not be processed without a personal statement. Please refer to the guidance notes for further assistance and continue on a separate sheet if necessary.
7.
Checklist The application package must contain these following items: a) A duly completed application form b) Certified copies of NRIC/Passport, academic/training certificates and transcripts c) Two passport-sized photographs d) Pre-course counselling checklist e) Programme application fee The complete application package should be returned to :
Director, UOP BA Programme (Part Time) Kaplan Higher Education Institute Pte Ltd. Kaplan City Campus @ Wilkie Edge 8 Wilkie Road, #02-01 Singapore 228095 Tel : (65) 6733 1877 Fax : (65) 6225 3605 Email :
[email protected] BRN: 198600044N
For official use only
Admission is Partner ID/ Registration Number:
☐
Recommended
☐
Declined
