Application for Lembaga Khairat Muslimin Madrasah Study Grant 2016 (Open for application from 1 st October 2016 to 1 st December 2016) Successful applicants will be awarded S$100 (per child) for part-time & S$300 (per child) for full-time study at any MUIS-recognized Madrasahs in Singapore Before filling in the form, please take note: Eligibility: Applicant must be a member of LKM Applicant s child must be studying full-time or part-time at recognized Madrasah in Singapore or a MUIS-approved institution at Primary to Tertiary level Applicant s child must not be receiving any scholarship or bursary from other organization Documents to Submit: Completed application form Copy of Child s Birth Certificate Identity letter from Madrasah/Mosque/Institution indicating that applicant s child is currently a student in the school; or Copy of latest 2016 official test/examination results transcript; or Copy of official receipt for payment of year 2016 tuition fees Copies of latest income documents of all working family members (Income Tax Notice of Assessment, IR8A, computerised payslip or employer's letter) Copy of latest 2016 official test/examination results transcript ** for full-time Madrasah students only ** The deadline for submission is 1 December 2016. Late, incomplete applications or lacking supporting documents will not be considered. Only successful applicants will be notified. Mail to Lembaga Khairat Muslimin (LKM) Polis Repablik Singapura 391 New Bridge Road, Police Cantonment Complex Blk A, #02-106 Singapore 088762 Or Email scanned copies to lkmprs@gmail.com Call 8322 5299 for more information
No. of children applying for Particulars of Applicant (LKM Member Only) Full Name NRIC. Rank / Svc No Div / Unit Marital Status. Date joined LKM / /. Is this your first time applying? Yes No Home. Address. Contact Details (mobile) (home) (office) Name of Bank (eg. DBS, POSB) (email address) Account Type Savings Current Fixed Deposit Account No. Gross Monthly Income No. of Dependants (inclusive of all allowances) $ (excluding working members). Particulars of Child(ren) on whose behalf this application is made LKM Madrasah Study Grant 2016 Page 1
# Only complete this portion if applying for more than 2 children LKM Madrasah Study Grant 2016 Page 2
Particulars of Other Family Members in the same household Declaration I declare that :- 1. My child(ren) on whose behalf this application for LKM Madrasah Study Grant is made is/are not currently in receipt of any study awards/bursaries/scholarships. 2. I understand that late submissions and/or incomplete applications will NOT be considered. 3. All the information provided by me in this form is true, correct and accurate to the best of my knowledge. 4. I understand that if any of the information provided by me in this form is false, inaccurate or misrepresented, the application will be rejected or withdrawn and I will be liable to repay in full the award granted. 5. I understand that the LKM Madrasah Grant Committee s decision is final. Signature of Applicant Date LKM Madrasah Study Grant 2016 Page 3.
For Official Use Date Application Received Total Household Gross Income No. of Household Members Gross Per Capita Income Approved By President / Vice President Name of Student(s) Result of Application Entitlement FT: $300 / PT: $100 Total Amount Awarded LKM Madrasah Study Grant 2016 Page 4