International Application Form

INTERNATIONAL STUDENT APPLICATION FORM
PRIVATE AND CONFIDENTIAL
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1. PERSONAL DETAILS 个人资料
Name as in Passport 姓名拼音*

Given Name 名Surname 姓
Name in Chinese Character 中文姓名

Given Name 名Surname 姓
Date of Birth 出生日期*

DayMonthYear
Gender 性别*

MaleFemale
Marital Status 婚姻状况*
Race 种族*

ChineseIndianMalayOther
Religion 宗教*
Nationality 国籍*
Birth Certificate No.出生证明书号码
Country of Birth 出生国家*
State /Province of Birth出生省份*
NRIC No.身份证号*
FIN No.
(if applicable)
Passport No.护照号码
Passport Issue Date 护照签发日期

DayMonthYear
Passport Expiry Date 护照有效期

DayMonthYear

Antecedent 先例*

	Please choose "Yes" or "No"
Have you ever been refused entry into or deported from any country? 你是否曾经被拒绝进入或被任何国家驱逐出境?
Have you ever been convicted in a court of law in any country? 你是否曾经被任何国家的法院的法律宣判有罪?
Have you ever been prohibited from entering Singapore? 你是否曾经被禁止进入新加坡?
Have you ever entered Singapore using a different Passport or Name? 你是否曾经使用不同的名字或护照进入新加坡?

If any of the answer is “YES”, please furnish details (如果以上任何答案是“是”，请提供详细信息)
Occupation 工作职称*
If you choose "Others", please specify your occupation.
2. CONTACT DETAILS 联系方式
Home Phone No.住家电话号码

Country CodeArea CodePhone Number
Mobile No.手机号码*

Country CodePhone Number
Email Address邮箱*
Correspondence Address (Please write in English) 英文通讯地址*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Correspondence Address (Please write in Chinese, only for applicant from China)中文通讯地址 (仅限中国学生)*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
List countries in which applicant has resided for one year or more during the last five years:
1) Country 国家*
Address 地址*
Street Address, City, State, Postal Code
Period of Stay居住时间 (From 从)*

DayMonthYear
Period of Stay居住时间 (To 到)*

DayMonthYear

Add More Country
2) Country 国家
Address 地址
Street Address, City, State, Postal Code
Period of Stay居住时间 (From 从)

DayMonthYear
Period of Stay居住时间 (To 到)

DayMonthYear

End Section

Add More Country
3) Country 国家
Address 地址
Street Address, City, State, Postal Code
Period of Stay居住时间 (From 从)

DayMonthYear
Period of Stay居住时间 (To 到)

DayMonthYear

End Section
Emergency Contact 家人/监护人联系资料

(immediate family members only)
Contact Name 家人或监护人姓名*

Given Name 名Surname 姓
Relationship 申请人的关系*

FatherMotherBrotherSisterOther
Home Phone No.住家电话号码

Country CodeArea CodePhone Number
Mobile No.手机号码*

Country CodePhone Number
Email Address邮箱*
3. COURSE WHICH YOU WISH TO APPLY 报读课程

Please indicate below the course you are applying for 请标明所要报读的课程:*

	Please choose one course 请选择一项
Foundation in Accounting & Business Study 会计与工商预科课程
Foundation in Management Accounting 管理会计预科课程
Postgraduate Diploma in Financial Services (Management Accounting) 金融服务研究生(管理会计)文凭
Postgraduate Diploma in Financial Services (Financial Management) 金融服务研究生(财务会计)文凭
Preparatory Course for CIMA Diploma in Management Accounting CIMA 管理会计文凭预科课程
Preparatory Course for CIMA Advanced Diploma in Management Accounting CIMA 管理会计高级文凭预科课程

4. ACCOMMODATION 住宿

(For International Applicants only 仅限国际学生)
Please indicate below do you need CITECH to help you to look for an accommodation in Singapore. 请标明是否需要特许科技学院帮你找住所*

YesNo
If your answer is ‘Yes’, please indicate your preference 如果你回答“是”，请作出如下选择 :

2 Persons to a room 两人间4 Persons to a room 四人间Other
5. FOR STUDENT PASS APPLICATION 学生签证申请信息

(For International Applicants only 仅限国际学生)
A. Applicant’s Natural Parents and/or Step Parents 申请者父母、继父母
1) Name as in Passport 护照姓名*

Given Name 名Surname 姓
Relationship 关系*
Date of Birth 出生日期*

DayMonthYear
Nationality 国籍*
Residential Status in Singapore 在新加坡的居民身份*

Singapore Citizen/Singapore PR NRIC No.:______________________Resident (Long-term Pass/ Work Pass/ Dependent Pass, etc) FIN No.:_______________________None of the above
Occupation 工作职称*
If you choose "Others", please specify your occupation.
2) Name as in Passport 护照姓名*

Given Name 名Surname 姓
Relationship 关系*
Date of Birth 出生日期*

DayMonthYear
Nationality 国籍*
Residential Status in Singapore 在新加坡的居民身份*

Singapore Citizen/Singapore PR NRIC No.:______________________Resident (Long-term Pass/ Work Pass/ Dependent Pass, etc) FIN No.:_______________________None of the above
Occupation 工作职称*
If you choose "Others", please specify your occupation.

Applicant’s Spouse Information
B. Applicant’s Spouse (If Applicable) 申请者配偶
Name as in Passport 护照姓名

Given Name 名Surname 姓
Relationship 关系
Date of Birth 出生日期

DayMonthYear
Nationality 国籍
Residential Status in Singapore 在新加坡的居民身份

Singapore Citizen/Singapore PR NRIC No.:______________________Resident (Long-term Pass/ Work Pass/ Dependent Pass, etc) FIN No.:_______________________None of the above
Occupation 工作职称
If you choose "Others", please specify your occupation.

End Section

Applicant’s Siblings Information
C. Applicant’s Siblings 申请者兄妹
1) Name as in Passport 护照姓名

Given Name 名Surname 姓
Relationship 关系
Date of Birth 出生日期

DayMonthYear
Nationality 国籍
Residential Status in Singapore 在新加坡的居民身份

Singapore Citizen/Singapore PR NRIC No.:______________________Resident (Long-term Pass/ Work Pass/ Dependent Pass, etc) FIN No.:_______________________None of the above
Occupation 工作职称
If you choose "Others", please specify your occupation.

End Section

Add More Siblings Information
2) Name as in Passport 护照姓名

Given Name 名Surname 姓
Relationship 关系
Date of Birth 出生日期

DayMonthYear
Nationality 国籍
Residential Status in Singapore 在新加坡的居民身份

Singapore Citizen/Singapore PR NRIC No.:______________________Resident (Long-term Pass/ Work Pass/ Dependent Pass, etc) FIN No.:_______________________None of the above
Occupation 工作职称
If you choose "Others", please specify your occupation.

End Section

Add More Siblings Information
3) Name as in Passport 护照姓名

Given Name 名Surname 姓
Relationship 关系
Date of Birth 出生日期

DayMonthYear
Nationality 国籍
Residential Status in Singapore 在新加坡的居民身份

Singapore Citizen/Singapore PR NRIC No.:______________________Resident (Long-term Pass/ Work Pass/ Dependent Pass, etc) FIN No.:_______________________None of the above
Occupation 工作职称
If you choose "Others", please specify your occupation.

End Section
D. Applicant’s Educational Background 申请者教育背景

(In Chronological Order)
1) Name of University 大学名称
Country 国家
State or Province省份
Language of Instruction学习语言

EnglishChineseOther
Period of Study学习时间 (From 从)

DayMonthYear
Period of Study学习时间 (To 到)

DayMonthYear
Name of Qualification 学历名称
Please submit a copy of certified true copy of certificates and transcripts.<br>请提交学位成绩，学位毕业证书公证书原件和复印件
If you choose "Others", please specify the name of your qualification.
2) Name of College/ Vocational Technology/ Polytechnic 学院/职业技术学院/理工学院名称
Country 国家
State or Province省份
Language of Instruction学习语言

EnglishChineseOther
Period of Study学习时间 (From 从)

DayMonthYear
Period of Study学习时间 (To 到)

DayMonthYear
Name of Qualification 学历名称
Please submit a copy of certified true copy of certificates and transcripts.<br>请提交专科毕业成绩，专科毕业证公证书原件和复印件
If you choose "Others", please specify the name of your qualification.
3) Name of High School 高中学校名称*
Country 国家*
State or Province省份*
Language of Instruction学习语言*

EnglishChineseOther
Period of Study学习时间 (From 从)*

DayMonthYear
Period of Study学习时间 (To 到)*

DayMonthYear
Name of Qualification 学历名称*
Please submit a copy of certified true copy of certificates and transcripts.<br>请提交高考毕业成绩，高考毕业证书公证书原件和复印件
If you choose "Others", please specify the name of your qualification.
Have you taken an English Language Test within the past 2 years?在过去2年里，你曾考过任何英语测试？*

No 否Yes 是

If ‘Yes’, please indicate and attach a copy of your respective English Result:

	Score
TOEFL 托福
IELTS 雅思
Others 其他

6. APPLICANT’S EMPLOYMENT HISTORY 申请者工作经历
1) Name of Company 公司名称
Country 国家
Period of Working工作时间 (From 从)

DayMonthYear
Period of Working工作时间 (To 到)

DayMonthYear
Position Held 职位
Nature of Duties 主要职责

Add More Company
2) Name of Company 公司名称
Country 国家
Period of Working工作时间 (From 从)

DayMonthYear
Period of Working工作时间 (To 到)

DayMonthYear
Position Held 职位
Nature of Duties 主要职责

End Section
7. FINANCIAL SUPPORT DETAILS 申请者财务状况

(To be completed by applicant from Visa-required countries)

Applicant 申请者*

	SGD
Average Monthly Income for past 6 months:
Current Saving (e.g. Fixed Deposit):

Applicant's Spouse 申请者配偶

	SGD
Average Monthly Income for past 6 months:
Current Saving (e.g. Fixed Deposit):

Applicant's Father 申请者父亲*

	SGD
Average Monthly Income for past 6 months:
Current Saving (e.g. Fixed Deposit):

Applicant's Mother 申请者母亲*

	SGD
Average Monthly Income for past 6 months:
Current Saving (e.g. Fixed Deposit):

Other financial supports from immediate family members: 其他财务支持*

Yes 是No 否
If you choose "Yes", please specify
8. RECOMMENDATION 推荐信

Please indicate below the name of the person or organisation who recommends this course to you. 请指出哪个人或哪个机构推荐你来读相关课程
Recommended By (Name of Person /Agent) 推荐(人/中介名字)
Name of Organisation/Agent 机构/中介名字
Address of the Person/Organisation/Agent 推荐人/机构/中介地址

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Contact No.推荐人/机构联系电话号码

Country CodeArea CodePhone Number
Email Address推荐人邮箱
9. REFUNDS AND WITHDRAWAL 退款和退学

As per Academic policies & regulations, please refer to CITECH’s official website for more information.

CITECH shall, inform the students within 3 working days, if:

it does not commence the Course on the Course Commencement Date;
it terminates the Course before the Course Commencement Date;
it does not complete the Course by the Course Completion Date;
it terminates the Course before the Course Completion Date;
it has not ensured that the Student meets the course entry or matriculation requirement as set by the Institute as stated in Schedule A of the Student Contract within any stipulated timeline set by Council for Private Education; or
the Student’s Pass application is rejected by Immigration and Checkpoint Authority (ICA), and/or after appealing to the respective authority is still being rejected by the ICA. Students will be required to pay for any fees charged by ICA if appeal is submitted to ICA. (Note: There will be no refund of student’s pass application fees or related fees charged by ICA to students.)
if the student’s application to the External Program is being rejected by the external partner (if any).

The Student shall be informed in writing of alternative study arrangements (if any), and also be entitled to a refund of the entire Course Fees and Miscellaneous Fees already paid should the Student decide to withdraw, within seven (7) working days of the above notice.

% of [the amount of fees paid under Schedules B and C as per student contract] 退款数额的百分比% [根据学生合约里的表B和C已支付的学费和杂费]	If student’s written notice of withdrawal is received 若已收到学生书面退学通知
90%	More than 14 days before the Course Commencement Date. 早于开课日期之前14 日
50%	Before, but not more than 14 days before the Course Commencement Date. 在开课日期之前，但不早于开课日期之前14 日
0%	After, but not more than 1 day after the Course Commencement Date. 在开课日期之后，但不晚于开课日期之后1日
0%	More than 1 day after the Course Commencement Date. 晚于开课日期之后1 日

Note: CITECH reserves the right to make changes to the terms and conditions without any prior notice. 备注：特许科技学院保留变更条款的解释权

REFUND DURING COOLING-OFF PERIOD
The Institute will provide the Student with a cooling-off period of seven (7) working days after the date that the Contract has been signed by both parties.
The Student will be refunded the highest percentage of the fees according to the above table already paid if the Student submits a written notice of withdrawal to the Institute within the cooling-off period, regardless of whether the Student has started the course or not.

10. DECLARATION 声明
- I declare that to the best of my knowledge, the information supplied above is correct and complete. I acknowledge that the provision of incomplete, misleading or fraudulent information may lead to the review or rejection of this application.
  本人声明，以上提供的信息真实完整。否则，这份申请表将被拒绝。
- I declare that the application may be used for purposes relating to my enrolment as a student of CITECH.
  本人声明该申请表用于攻读特许科技学院课程的入学申请。
- I declare that I have the right to see and correct if necessary the information that I have provided.
  本人声明我有权更改我已提供的信息。
- I declare that I know I must not engage in any illegal activities if I am selected to enrol into the program. This will result in being rejected to continue my education and be deported to my country.
  本人声明我了解如果参加该课程，不能参加违法活动。否则我会被拒绝继续教育，遣返回国。
Applicant’s Signature 申请人签名*
Date 日期*

DayMonthYear
11. CONTACT DETAILS OF CITECH 联系方式
If you have any queries regarding the application process or course information, please contact our course consultant at: 关于课程及申请进程信息如有问题，请及时与我们联系:

Singapore 新加坡
Chartered Institute of Technology 特许科技学院
Address 地址: 450 Telok Blangah Street 31, Singapore 108943
Tel 电话: (65) 6276 4890
Fax 传真: (65) 6276 5901
Email 邮箱: enquiry@citech.edu.sg
12. ESCROW INFORMATION 以下是第三方托管银行账户信息

Payment by Cheque(s), please make payable to Chartered Inst of Tech PL STFA (Escrow).
Payment by Telegraphic Transfer, you may refer below for the escrow account information.

Name of Bank : 银行名称	DBS Bank Ltd
Escrow Account Name : 银行账户名称	Chartered Inst of Tech PL STFA (Escrow)
Escrow Account Number : 银行账户号码	003-923691-3
DBS Swift Code : 银行代码	DBSSSGSG
DBS Bank Address : 银行地址	DBS BANK LTD 12 Marina Boulevard DBS Asia Central Marina Bay Financial Centre Tower 3, Singapore 018982

13. CONDITIONS OF ENROLMENT 入学条件

For Foundation in Accounting & Business Study
会计与工商预科课程:
Minimum age of 16 years old, applicant completed either the
年龄不低于16岁，完成学业:

High School Education (G.C.E ‘A’ Level/STPM/UEC) 高中
Secondary School Education (G.C.E ‘O/N’ Level/SPM) 初中

For Foundation in Management Accounting Course
管理会计预科课程:
Minimum age of 19 years old, applicant completed either the
年龄不低于19岁，完成学业:

Bachelor degree in any discipline
具有非相关会计，金融和工商管理学士学位或
Other qualifications will be evaluated on a case-by-case basis
其他学历是根据特殊情况来进行判定
English language proficiency requirements for international students is G.C.E. "O" level or high school level or equivalent
英语要求：必须通过高考英语或同等学历

For Postgraduate Diploma Course
研究生课程 :
Minimum age 19 years old, applicant completed either the
年龄不低于19岁，完成学业:

Applicants must be holders of Bachelor Degrees related to Accounting, Finance and Business Management
具有相关会计，金融和工商管理学士学位或
Applicants from non-related degrees with CITECH Foundation in Management Accounting
具有非相关会计，金融和工商管理学士学位和具有特许科技学院颁发的管理会计预备课程证书
Other qualifications will be evaluated on a case-by-case basis
其他学历是根据特殊情况来进行判定
Min. English IELTS 5.5 or equivalent
英语雅思要求平均分达到5.5

For Preparatory Course For CIMA Diploma Course/ Preparatory Course For CIMA Advanced Diploma Course
CIMA专科文凭预科课程/CIMA高级专科文凭预科课程:
The minimum entry requirement is either one of the following criteria:
必须满足以下条件的一项：

Students who have completed the CIMA Certificate in Business Accounting
学生已经获得CIMA商业会计证书
Students who have completed a relevant diploma or degree
学生已经获得其相关文凭或者学位证书
Other qualifications will be evaluated on a case-by-case basis
其他学历是根据特殊情况来进行判定
Preparatory Course For CIMA Diploma Course: CIMA专科文凭预科课程:
- Students who have completed CITECH Diploma in Accounting and Finance学生已经获得CITECH会计与金融专科文凭
Preparatory Course For CIMA Advanced Diploma Course: CIMA高级专科文凭预科课程:
- Student who have completed CITECH Postgraduate Diploma in Financial Services (Financial Management)
  学生已经获得CITECH金融与服务管理（财务管理）研究生文凭
- Students who have completed the CIMA Diploma in Management Accounting
  学生已经获得CIMA管理会计专科文凭

14. CONFIDENTIALITY CLAUSE 保密条款
CITECH is committed to maintaining the confidentiality of the student’s personal information and undertakes not to divulge any of the student’s personal information to any third party without the prior written consent of the student subject to the obligation of CITECH to disclose to any Singapore government authority any information relating to the student in compliance with the law and/or to the organisation conferring/ awarding the qualification.
特许科技学院保证维护学生个人信息隐私权，未经学生书面同意时不将学生个人信息披露给第三方；除非特许科技学院为遵守新加坡法律需要，有义务向新加坡政府机关或授予资格的组织披露相关信息。

By providing the information in this form, I have given consent to the Institute that the information given will be used for the administration, processing, and evaluation of my application by CITECH and/or its Partners. In addition, the information provided will be used for the provision of students’ support and administrative services rendered to me. This information will be kept by CITECH and/or its Partner for the dissemination of information including services and products offer by CITECH. For more information on CITECH’s data protection policy, please refer to http://www.citech.edu.sg/stud_pdpa.htm.
我授权特许科技学院和/或其合作伙伴使用我在此表格内所提供的所有个人信息。此外，特许科技学院和/或其合作伙伴也可以在学生服务和行政管理上使用我所提供的个人信息。我也同意特许科技学院和/或其合作伙伴保留我的个人信息，并且使用在宣传产品和服务上。欲进一步了解特许科技学院信息保护条款，请查阅网页http://www.citech.edu.sg/stud_pdpa.htm。
15. CHECKLIST第十五部分 - 资料准备例表

Your application cannot be processed unless all questions are answered and all supporting documents are attached. Before submission, kindly go through the list of items below to ensure that you have fully completed and furnished the necessary documents and choose accordingly. Please enclose the listed documents below together with this application form. Photocopies must be certified as true copies of the originals. The examining authority or registrar of your school, lawyer or notary public can do this.你必须如实回答所有问题和准备好全部资料后，特许科技学院将受理你的申请。请核对并提供相关申请文件。相关证明文件由公证处公证并提供复印件。请将以下所列出的文件连同这张表格一起发送。*

	Please choose "Yes" or "No"
1) Certified True Copy of your Birth Certificate (original and photocopied set) 出生证明公证书原件和复印件: 1 set each 各1份
2) Certified True Copy of High School Certificate (original and photocopied set) 高考毕业证书公证书原件和复印件: 1 set each 各1份
3) Certified True Copy of High School Results (original and photocopied set) 高考毕业成绩单公证书原件和复印件
4) Certified True Copy of Diploma Results (original and photocopied set) 专科毕业成绩公证书或在籍成绩证明公证书原件和复印件: 1 set each 各1份
5) Certified True Copy of Diploma Certificate (original and photocopied set) 专科毕业证公证书原件和复印件: 1 set each 各1份
6) Certified True Copy of Degree Results (original and photocopied set) 学位成绩公证书或在籍成绩证明公证书原件和复印件: 1 set each 各1份
7) Certified True Copy of Degree Certificate (original and photocopied set) 学位毕业证书公证书原件和复印件: 1 set each 各1份
8) Photocopy of the IELTS/TOEFL Results 雅思或托福考试成绩复印件: 1 set each 各1份
9) Fill up and return the CITECH Student Application Form 提交填写完整的CITECH课程申请表格: 1 set each 各1份
10) Photocopy of Passport 护照复印件: 1 set each 各1份
11) Passport Size Photos (with white background) 同护照尺寸照片 (白底): 2 set each 各2份
12) Certified True Copy of Bank Statement Savings of RMB150,000 (for one year course)/ RMB75,000 (for one semester course) (original and photocopied set) (for China) 人民币150,000 (一学年课程）/ 人民币75,000 (一学期课程) 银行存款证明公证书原件和复印件 (只限中国公民): 1 set each 各1份

Should be Empty:

INTERNATIONAL STUDENT APPLICATION FORM

1. PERSONAL DETAILS 个人资料

2. CONTACT DETAILS 联系方式

3. COURSE WHICH YOU WISH TO APPLY 报读课程

4. ACCOMMODATION 住宿

5. FOR STUDENT PASS APPLICATION 学生签证申请信息

6. APPLICANT’S EMPLOYMENT HISTORY 申请者工作经历

7. FINANCIAL SUPPORT DETAILS 申请者财务状况

8. RECOMMENDATION 推荐信

9. REFUNDS AND WITHDRAWAL 退款和退学

10. DECLARATION 声明

11. CONTACT DETAILS OF CITECH 联系方式

12. ESCROW INFORMATION 以下是第三方托管银行账户信息

13. CONDITIONS OF ENROLMENT 入学条件

14. CONFIDENTIALITY CLAUSE 保密条款

15. CHECKLIST第十五部分 - 资料准备例表