Application for admission to the Part-Time Bachelor of Technology Programme
(Academic Year 2012/2013 Intake II, commencing in January 2013)
You will need the following documents to complete the form:
1.
2.
3.
4.
5.
Secondary Education results – 'O' level result (Singapore Cambridge GCE/SPM/Cambridge GCE/EdexcelLondon).
Polytechnic results – to count the number of grades obtained for all semesters or first 5 semesters.
GCE 'A' level/STPM result, Advanced diploma, Degree transcript, Degree scroll, SAT, TOEFL, IELTS (if any).
National Service (For Male Singaporean or Singapore Permanent Resident Only.)
Employment Information - Present & previous employment, including the dates of joining and leaving.
NOTE:

Please TYPE on the form (pages 1 to 6); print a copy after entering all the details and sign on it.

If you apply for more than one course, you will need to make a non-refundable application fee of $20 for each course
you are applying. For example: If you apply for 3 courses, you will have to pay $60 non-refundable application fee.
A. Choices of Courses
1st Preference
I wish to apply for (If you
wish to apply for more
than one course, please
choose your preferences
in ascending order)
2nd Preference
3rd Preference
4th Preference
B. Personal Particular
First Name (also termed
as: Given Name)
E.g.: Yan Leng, Yvonne
Last Name (also termed
as: Family Name or
Surname)
E.g.: Tan
Name
(as printed on your passport or birth certificate according to the requirements of the Singapore
Immigration and Checkpoint Authority)
Date of Birth
(dd/mm/yyyy)
Place of Birth
Gender
Marital Status
Citizenship
Type of NRIC
NRIC/FIN Number
Passport Number
Race/Ethnic Group
Religion
Employment Pass
(applicable for foreigner
only)
National Service (For Male Singaporean or Singapore Permanent Resident Only.)
NS Status
Enlistment Date
Contract Service
(dd/mm/yyyy)
Enlistment ORD
Yes
No
(dd/mm/yyyy)
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C. Contact Information
Address
Block/House No.
Unit Number
E.g. 675A
Street Name
E.g. #11-345
Postal Code
Email
Home Telephone
Handphone Number
D. Academic Qualifications
Secondary Education
Country
Name of Sec. School
Entry Date
Leave Date
(mm/yy)
(mm/yy)
Type of Examination
Please fill out this section ONLY if the Type of Examination is SingaporeCambridge GCE O Level OR Sijil Pelajaran Malaysia (SPM) OR Cambridge O
Level OR Edexcel/London O Level
Note: If you have taken GCE O level on more than once occasion, please indicate the better
grade of the subjects that you have taken based on the best 2 sitting. For example: For
History grade of B3 in 1983 and History grade of A2 in 1984; please fill in grade A2 for History.
However, you should submit the result slips for all sittings taken for our verification.
Subject Name
Grade obtained
Secondary Examination
Result
Please fill out this section ONLY if the Type of Examination is “Others”
Name of Examination
GPA
Average
Percentage
Mark
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Polytechnic Institution
Name of Polytechnic
Country
Date of Admission
Date of Graduation
(mm/yy)
(mm/yy)
Diploma Course
Diploma Taken
Full-time
Part-time
Number of Year Taken
for Diploma Course
Years
Months
Please fill out this section ONLY if diploma awarded is NOT from one of the
five local polytechnic.
Classification of Diploma
Diploma Result
Average
Percentage
Mark
GPA
Please fill out this section ONLY if diploma awarded is from one of the five
local polytechnic.
Total Number of Each Grade Obtained during Diploma Course
Dist
A
B
C
D
E
F
P
Did you repeat any year/semester in the diploma course?
Yes
No
Did you change course during the course of study?
Yes
No
Were you on medical leave/leave of absence for 1 semester or more during year
course of study?
Yes
No
Yes
No
Advanced Diploma
Are you currently pursuing or have completed an advanced diploma?
If the answer is “Yes”, please fill out this section.
Country
Name of Polytechnic
Name of Advanced Diploma
Yes
Completed?
No
Please fill out this section ONLY if you HAVE COMPLETED the advanced
diploma.
Date Awarded
(dd/mm/yyyy)
GPA
out of
Page 3 / 10
University Education
Are you currently enrolled in, or have previously been admitted into a degree course
from one of the local/overseas universities (whether or not you have completed the
course)? Note: You should indicate ‘Yes’ even if you have withdrawn from that
university shortly after being admitted and have not taken any university
examination. If the answer is “Yes”, please fill out this section.
Yes
No
Country
Name of University
Name of Degree
Specialization
Yes
No
Please fill out this section ONLY if you HAVE COMPLETED the degree
course.
Date Awarded
GPA
out of
(dd/mm/yyyy)
Completed?
Classification of Degree
Please fill out this section ONLY if you HAVE NOT COMPLETED the degree
course.
Year Admitted
Reason for leaving
Withdrawal from the Programme
Dismissed by the University
Reason for Withdrawal/Dismissed
Additional Information (Please provide, if applicable)
ITE
Yes
No
A-Level/STPM
Yes
No
Yes
No
If “Yes”, please specify
International English
Language Testing System
(IELTS)
If “Yes”, please specify
Overall band Score
Date Awarded
Scholastic Aptitude Test
(SAT)
If “Yes”, please specify
Score
Date Awarded
Test of English as a Foreign
Language (TOEFL)
If “Yes”, please specify
Type
(dd/mm/yyyy)
Yes
Verbal
No
Maths
Writing
(dd/mm/yyyy)
Yes
No
Paper
Computer
Internet
Score
Date Awarded
(dd/mm/yyyy)
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E. Employment Information
Total Duration of Working Experience From Current and Previous Employment
Years
Months
Yes
No
Present Employment
Are you currently employed?
If the answer is “Yes”, please fill out this section.
Company Name
Designation
Date Joined
Organization Sector
Present Salary Range
(mm/yy)
Previous Employment
Do you have any employment history?
Yes
If the answer is “Yes”, please fill out this section.
S/N
Name of Company
Designation
Date Joined
(mm/yy)
No
Date Left
(mm/yy)
1.
2.
3.
F. Next-of-Kin / Guardian Information
Name of Kin/Guardian
Relationship
Telephone Number
Hand phone
G. Disability and Special Needs
Have you had or do you have any communicable diseases,
mental illness, colour blindness, and/or disabilities (including
but not limited to chronic illnesses, visual or other physical
constraints or limitations) which may or may not cause you to
require special assistance or facilities while studying at the
University?
Yes
No
If the answer is “Yes”, please provide all relevant information on a
separate sheet of paper and attach the relevant medical documents.
Note: This information will enable the University to develop a complete
profile of an applicant and to determine whether he/she might need
additional resources in his/her studies. The University does not,
however, guarantee the provision of special aid (financial or otherwise)
to any student.
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H. Other Information
Source of Finance
Self-Support
Are you applying for any other degree programme(s) at NUS,
NTU or overseas institution for the coming session?
Yes
No
Yes
No
Yes
No
Company Sponsorship
If the answer is “Yes”, please specify
Have you applied for any B.Tech Programmes before?
If the answer is “Yes”, please specify number of attempt:
How do you come to know about the admission?
1)
Have you ever been convicted of any offence by a court
of law in any country or are there any court proceedings
pending against you anywhere in respect of any offence?
2)
Are you currently, or have you ever been, charged with
or subject to disciplinary action for any type of
misconduct, scholastic or otherwise, at any educational
institution?
3)
Are you currently, or have you ever been, under
investigation or subject to enquiry in respect of any
misconduct, scholastic or otherwise, at any educational
institution?
If your answer to any or all of the above questions is “Yes”, please
provide a full statement of relevant information and attach the relevant
documents.
Any other comments?
I. Declaration
I hereby declare that all information provided by me in connection with this application is
true, accurate and complete. I understand that any inaccurate, incomplete or false
information given or any omission of information required shall render this application
invalid and NUS may at its discretion withdraw any offer of acceptance made to me on
the basis of such information or, if already admitted, I may be liable to disciplinary
action, which may result in my expulsion from NUS. I understand that the provision of
any inaccurate or false information may render me liable to prosecution in a court of law
in Singapore. And I hereby authorise NUS to obtain and verify any part of the
information given by me from or with any source, as it deems appropriate.
____________________________
Signature of Applicant
____________________
Date
Page 6 / 10
Application for admission to the Part-Time Bachelor of Technology Programme
(Academic Year 2012/2013 Intake II, commencing in January 2013)
Checklist of documents to be submitted
Name:
NRIC/FIN:
Course(s) applied:
Chemical Engineering
Industrial & Management Engineering
Electronics Engineering
Mechanical/Manufacturing Engineering
Please submit the following documents to B.Tech office no later by 7th June 2012:
Checklist of documents to be submitted
Application form
All required supporting documents
Payment receipt(s)
Mailing address of B.Tech office:
National University of Singapore
Bachelor of Technology Programme
Engineering Blk EA #07-32
9 Engineering Drive 1
Singapore 117576
Attention: Veronica/Amanda
NOTE:
A submitted supporting document that is not in English must be accompanied by a translation of the
same in English. Original certificates and documents MUST NOT be submitted with your application.
The National University of Singapore will not be responsible for damage or loss of original certificates or
documents submitted where these have not been asked for.
Page 7 / 10
Please ensure that all the required supporting documents to be submitted are ticked in the respective
boxes using a PEN.
S/N
Documents
Tick
Remarks (if any)
Required supporting documents (For Singaporeans)
1
Identity card (pink)
2
'O' level result (Singapore Cambridge GCE/SPM/Cambridge
GCE/Edexcel-London)
3
Diploma transcript and diploma scroll
GCE 'A' level/STPM result, Advanced diploma, Industrial Trade
Certificate, Degree transcript, Degree scroll, SAT, TOEFL,
EL1119, MUET, IELTS (if any)
Company sponsorship letter (if any) - Letter from the company
5
if applying for company sponsorship
Employment - Letters certifying periods of present & previous
6
employment. The dates of joining and leaving MUST be
indicated in the document
National Service (NS) letter with expected date of completion
7
of service. (Applicable to applicants who are still serving NS)
Required supporting documents (For Singapore PRs)
4
1
Identity card (blue)
2
Passport, Entry Permit AND Re-entry Permit
3
'O' level result (Singapore Cambridge GCE/SPM/Cambridge
GCE/Edexcel-London)
4
Diploma transcript and diploma scroll
GCE 'A' level/STPM result, Advanced diploma, Industrial Trade
5
Certificate, Degree transcript, Degree scroll, SAT, TOEFL,
EL1119, MUET, IELTS (if any)
Company sponsorship letter (if any) - Letter from the company
6
if applying for company sponsorship
Employment - Letters certifying periods of present & previous
7
employment. The dates of joining and leaving MUST be
indicated in the document
Required supporting documents (For Foreigners)
1
Work Permit / Employment Pass / S Pass
2
Passport
3
Secondary School results (if any)
4
Diploma results for ALL YEARS and Diploma scroll
5
6
7
Advanced diploma, Industrial Trade Certificate, Degree
transcript, Degree scroll, SAT, TOEFL, EL1119, MUET, IELTS (if
any)
Company sponsorship letter (if any) - Letter from the company
if applying for company sponsorship
Employment - Letters certifying periods of present & previous
employment. The dates of joining and leaving MUST be
indicated in the document
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Important Information
Closing date to apply for admission for





Chemical Engineering
Electronics Engineering
Industrial & Management Engineering
Manufacturing Engineering
Mechanical Engineering
AY2012/2013 Intake II (Intake commencing in January 2013) is on 1 June 2012.
Notes:
 Applicants may be short listed to sit for compulsory admission test(s) and/or interview.
o
Schedules for the admission tests:
 Maths – Saturday, 11 August 2012
 Chemical / Electronics / Mechanics – Saturday, 1 September 2012
Applicants shortlisted for the tests will be notified via email by mid of July 2012. There are no
make up papers if any shortlisted applicant is unable to sit for the admission tests on the
arranged schedules. The result of the tests would be considered in the admission selection
process and the application to the B.Tech course will be considered rejected if any shortlisted
applicant is unable to sit for the admission tests.
o

Interview will be held in early October 2012. Applicants shortlisted to attend for an interview
will be notified via email by end of September 2012.
All applicants will be able to know the outcome of their applications (whether Successful or
Unsuccessful) by mid October 2012.
=================================================================
Programme Briefing Session for ALL B.Tech Programmes
Details of the briefing session are as follows:
Date : Tuesday, 29 May 2012
Time : 7pm
Venue : NUS, Faculty of Engineering, Blk EA, Engineering Auditorium
The Director of the B.Tech Programme, Professor Poo Aun Neow is giving a short briefing on the
programmes, followed by FAQs. Registration is FREE and light refreshment will be served.
For catering purposes, please register your attendance at https://btech.eng.nus.edu.sg
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Foundation Modules Program
The Foundation Modules Program is a short refresher course, specially designed according to B.Tech
Programme Modules and it is aim to strengthen the foundation of students in mathematics and basic
engineering topics so that they will be better able to cope with the B.TECH Programme if they are
admitted and have better chances of doing well in their courses. These courses are optional and
attendance is not required for admission to the B.TECH Programme. It is entirely up to each individual if
he/she wishes to attend. This program is also opened to PUBLIC as it is suitable for diploma holders
intending to pursue further university education either locally or overseas.
To be well prepared for and to do well in a good engineering course in a university, students require a
strong foundation in mathematics & engineering. The courses which are available are Mathematics,
Electronics Engineering, Chemical Engineering and Mechanical Engineering. Mathematics is suitable for
any B.TECH course applied for while each of the other courses is specific only to the B.TECH course applied
for. Due to limited seats, the registration is on first come first served basis.
Fees
 Single Module - $400
 Double Modules - $750
(Price is inclusive of 7 % GST and a non-refundable administrative fee of SGD20.00)
Schedules
 Mathematics
o Consecutively for 4 weeks starting on 4 June 2012
o Consist of 8 lecturers and 4 tutorials
o Closing date for registration: 30 May 2012

Disciplines (Chemical, Electronics and Mechanics)
 Consecutively for 4 weeks starting on 2 July 2012
 Consist of 8 lecturers and 4 tutorials
 Closing date for registration: 26 June 2012
For more details and to register, please refer to http://www.eng.nus.edu.sg/PACentre/pac_fmp.htm
For further enquiries, please send an email to pac-fmp@nus.edu.sg
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