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NANYANG JUNIOR COLLEGE
WORK ATTACHMENT PROGRAMME 2014
APPLICATION FORM
1st Choice:
2nd Choice:
Period of Attachment:
Period of Attachment:
Selected for: (for Official Use)
PART A: APPLICANTS PARTICULARS
Name as in NRIC:
NRIC:
Civics Class:
Civics Tutor:
Current CCA Involvement:
Position (if any):
Content Subjects (pls indicate H1/H2):
H2 H2 H2 H1/H2
Age:
Date of Birth:
Race:
Religion:
Gender: M / F
Citizenship: Country of Birth:
Home Address:
Home Telephone:
Mobile:
Email Address:
PART B: CCA INVOLVEMENT (Previous & Current)
Period (Year) School CCA Position Held
Affix a Recent
Passport-sized
Photo Here
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PART C: ACHIEVEMENTS (Previous & Current)
Highlight any academic or CCA competitions participated at the inter/intra-school level
Period (Year) CCA Competition Award
PART D: ACADEMIC QUALIFICATIONS
O Level Results L1R5 (Raw):
Subject English Grade Subject Grade
Subject Grade Subject Grade
Subject Grade Subject Grade
Subject Grade Subject Grade
Subject Grade Subject Grade
JC Results (for JC2s only)
Promotional Examination Block Test
Subject Grade Subject Grade
H1 GP H1 GP
H2 H2
H2 H2
H2 H2
PART E: LANGUAGE & IT PROFICIENCY
Language/Dialect Level of Proficiency IT Skills Level of Proficiency
Fair / Good / Excellent Microsoft Word Fair / Good / Excellent
Fair / Good / Excellent Microsoft Excel Fair / Good / Excellent
Fair / Good / Excellent Microsoft Powerpoint Fair / Good / Excellent
Fair / Good / Excellent Others: Fair / Good / Excellent
PART F: PARENTAL CONSENT
I ____________________________, parent/guardian* of ______________________________,
acknowledge my childs/wards* participation in NYJC Work Attachment Programme in the
abovementioned period during the holidays should he/she be selected for the programme.
*delete accordingly
Signature:___________________________________ Date:_______________
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PART G: CIVICS TUTORS RECOMMENDATION
Kindly refer to your email for more details on CTs recommendation
I am aware that this student is applying for the abovementioned attachment.
Name & Signature:___________________________________ Date:_______________
PART H: PERSONAL ESSAY
Why are you applying for this attachment and what do you hope to achieve at the end of the
programme?
Submit this application form to Ms Sharon Teys Letter tray (No.8) before the deadline.
Shortlisted candidates may be notified to attend an interview.