Application for the Visiting Scholar and Visiting Researcher Programme Programme Application for (check only one) : Visiting Scholar Visiting Researcher Application Deadlines: Semester One (August to November) Semester Two (January to April) Vacation (May to July) : 1 May of the visit year : 1 October of the previous calendar year : 1 February of the visit year Instructions: Please complete this 2-page form and return to NUS Law Faculty along with a copy of your curriculum vitae, a one-page description of your intended research project, a letter of recommendation from an academic referee, and documentation of English-language proficiency. All materials must be submitted in English. Please print all information. Duration of Visit The proposed duration should be no longer than 2 months. Arrival: Day Month Year Departure: Day Month Year Academic Information: Area(s) of Specialization: Research Topic while at NUS: Highest Academic Degree in original language: NUS Law Faculty Sponsor (if unknown, please leave blank): Have you previously been associated with NUS Law Faculty? Yes If Yes, when? In what capacity: Please indicate level of English competency: Excellent Very Good Good No Fair Poor Financial Information Once accepted into the program, the NUS Law Faculty may require Visiting Scholars and Researchers to provide documentation of their ability to support themselves financially while in Singapore. Please list all funding sources Programme Fee A nominal programme fee may be applicable for applicants from OECD member countries. Checklist Please indicate whether you have submitted the following materials: curriculum vitae one-page list of publications one-page description of research project 1 letter of recommendation documentation of English language proficiency Please e-mail (preferred) or mail this 2-page form and the supporting documents to: Ms Kris Zhao National University of Singapore, Faculty of Law 469G Bukit Timah Road, Eu Tong Sen Building Singapore 259776 Phone: +65 6516 3600 E-mail: law.research@nus.edu.sg HR 055/13 PERSONAL PARTICULARS FORM 1. APPLICATION Position applying for: Department: Are you currently applying for/holding* a position in another department in NUS? If yes, specify department/staff no.*: 2. Yes No PERSONAL PARTICULARS Full Name as in Passport/Identity Card (underline Family Name): Name in Chinese Character, if applicable: Prof/Dr/Mr/Mrs/Ms* Home/Postal Address: SSer Contact Nos. Singapore Citizen NRIC/UIN No.*: Singapore Permanent Resident (SPR) (Attach a copy of Entry Permit) Date SPR granted: Date SPR expires: Served National Service (Attach a copy of NS certificate) Date enlisted: Service type: SAF/SPF/SCDF* Highest rank attained: Handphone: Home: Date discharged: Office: Fax: Non-Singapore Citizen and Non-SPR Email: Passport No.: Place of issue: Nationality: Date of issue: Date of expiry: Date of birth: Country of birth: Personalized Employment Pass (PEP) holder (Attach copies of PEP endorsement & card) Ethnic group: Religion: PEP No.: Gender: Male/Female* Marital status: Date of Issue: Name & address of present employer: Date of expiry: Present appointment: Date of present appointment: Present gross annual salary (specify currency): If appointed: Resigning from present appointment Taking leave from present appointment Have you received any award/scholarship that requires you to fulfill a service obligation? If yes, please specify period of service obligation & Yes No Yes No organization that you served it out with. If you have not successfully completed your service obligation, please provide details in a separate sheet of paper. Is your immediate family member presently working in the University? If yes, please state post & department. Immediate family member includes a spouse, child, parent, sibling, parent-in-law or domestic partner. 3. FAMILY PARTICULARS Full name Date & place of birth Nationality Occupation Address Father Mother Spouse Child(ren) 4. DECLARATION I declare that the particulars in this application are true to the best of my knowledge and belief, and I have not willfully suppressed any material fact. Signature of applicant: * Delete as appropriate Date: