STEER
STUDY TRIP
FOR ENGAGEMENT AND ENRICHMENT
APPLICATION FORM FOR STEER COSTA RICA
(+ PANAMA) 2016
5 – 22 December 2016
Theme: “Understanding Costa Rica and Central America – its History, Peoples and
Cultures, Biodiversity & Conservation and Business Opportunities”
INSTRUCTIONS
o This application is to be duly completed.
o Do not edit/delete any pages or fields in this application form.
o Late and incomplete application forms received will not be considered.
APPLICATION PROCEDURES
o Applications should be submitted to IRO or emailed to randallong@nus.edu.sg latest by
Sunday, 14 August 2016.
o Successful candidates will be notified by early to mid-September 2016. Shortlisted candidates
may be called for an interview.
o A complete application package should include the following:
 Completed application form (incomplete application forms will not be considered)
 CV / Resume (inclusive of any voluntary, extra-curricular, work experience, research
experience, etc.)
 Copy of latest NUS unofficial transcript
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STEER
STUDY TRIP
FOR ENGAGEMENT AND ENRICHMENT
APPLICATION FORM FOR OUTBOUND STUDENTS
(Please click in the box to insert your photo)
Submission deadline: Sunday, 14 August 2016
1. PARTICULARS OF STUDENTS
Full Name of Applicant (as it appears in Identity Card/Passport)
First Name
Family Name
Salutation (Mr/Ms)
Matriculation number
Date of Birth (dd/mm/yyyy)
Gender (Male/Female)
Religion
Language(s) spoken
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STEER
STUDY TRIP
FOR ENGAGEMENT AND ENRICHMENT
Home Address
Postal code
Country
Mailing Address(if different from above)
Postal code
Country
Citizenship
Identity card number
Passport number
Passport issue date
Mobile:
Passport expiry
Home:
(Country code - tel no.)
NUS email address
(Country code -
tel no.)
Personal email address(es)
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STEER
STUDY TRIP
FOR ENGAGEMENT AND ENRICHMENT
2. PARTICULARS OF NEXT-OF-KIN
Salutation (Mr/Ms)
Name
Relationship
Home Address
Country
Postal code
Email Address(es)
Telephone No:
Mobile No:
(Country code -
tel no.)
(Country code -
tel no.)
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STEER
STUDY TRIP
FOR ENGAGEMENT AND ENRICHMENT
3. NUS ACADEMIC PARTICULARS
Current CAP score
Faculty and department
Major
Year of study in NUS
Expected graduation date
Have you previously gone on
If yes, please specify the programme(s) and dates
SEP, NOC, or any other overseas programmes?
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STEER
STUDY TRIP
FOR ENGAGEMENT AND ENRICHMENT
4. PERSONAL STATEMENTS
1. Tell us, in no more than 100 words, why you should be selected to represent NUS in the STEER
programme.
2. Tell us, in no more than 100 words, what you hope (a) to contribute to and (b) to gain from
participating in the STEER programme
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STEER
STUDY TRIP
FOR ENGAGEMENT AND ENRICHMENT
3. Tell us, in no more than 500 words, what you think is the most challenging issue for Costa Rica and
why. As a student, what do you think can you do to address the issue?
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STEER
STUDY TRIP
FOR ENGAGEMENT AND ENRICHMENT
5. DECLARATION BY APPLICANT
Please indicate your agreement to the following statements by clicking in each box to tick it.
I wish to apply to participate in the STEER programme, and declare that all the
information submitted in this application is correct and complete.
I acknowledge that NUS reserves the right to vary or reserve any decision regarding
nomination made on the basis of incorrect or incomplete information.
I have read and understood all the terms and conditions of participation in this
programme, and will not hold NUS nor the organizers liable for any losses, claims,
demands, actions, proceedings, damages, costs, expenses and any other liability
arising in any way from my participation in the programme.
I hereby give consent to NUS to collect, use, disclose and/or process my personal data
hereby provided to partner universities, organizations, foreign regulatory and
governmental authorities and sponsors for the purpose of my application for the
STEER programme, financial aid, and subsequent related activities.
Full name (as in passport)
: ___________________________________
Date
: ___________________________________
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