SUNWAY EDUCATION GROUP ELENA COOKE EDUCATION FUND

2017 SCHOLARSHIP APPLICATION FORM

MINIMUM QUALIFICATIONS BEFORE APPLYING

Applicant must have obtained at least 3As in the Sijil Pelajaran Malaysia (SPM) and must
meet the course requirements of the college / university applied for.
Applicant must be below 23 years old as at 31st December 2016.
Applicant must be a Malaysian citizen.
Household income must not be more than RM42,000.00 per annum.
Applicant has not yet commenced his/her course in the college/university applied for.

INSTRUCTIONS
(Read the following carefully before filling the form. Incomplete forms will be rejected.)
1. State clearly in BLOCK LETTERS and complete all the sections.
2. If space is insufficient, please continue on a separate sheet and attach it to the application form.
3. Attach certified true copies in this order:
SPM and / or STPM certificates (trial exam results will not be accepted).
NRIC.
LATEST results obtained in college (where applicable).
Final year school leaving certificate and testimonial.
Financial statements for parents/guardian/main household income earner as listed in
Section G.
All documents submitted will become the property of ECEF and will not be returned to
the applicant.

4. Applicant, if short-listed, must attend an interview in the Klang Valley at own expense.
5. No correspondence will be entertained. Only short-listed applicants will be notified by email.
6. The amount of the scholarship, if granted, will be at the sole and absolute discretion of the
Elena Cooke Education Fund.
7. Send completed application form and all attachments by Pos Laju (NOT Pos Express) /courier /
hand to :
ELENA COOKE EDUCATION FUND
c/o Unit 1211, Level 12, Block A,
Damansara Intan e-Business Park,
No: 1 Jalan SS 20/27,
47400 Petaling Jaya, Selangor D.E.

8. The application must be received by 5.00 pm, 27th March 2017. Late applications will be
rejected.

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SECTION A: PERSONAL INFORMATION

Name (as per NRIC)

NRIC No.

Date of Birth Gender: Male Female

Home Address Please attach recent

colour photo
(passport size)

Tel. No. (House) (Mobile)

Email Address

SECTION B: ACADEMIC QUALIFICATIONS

Results of others (Certificate,

Results of SPM Results of STPM
Diploma, Matriculation)
State Qualification:

School/College: School/College: School/College:

Year : Year : Year :

Subject Grade Subject Grade Subject Grade

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 SECTION C: COLLEGE/UNIVERSITY & COURSE
For applications to Sunway College/University, ECEF scholarships are only open for the
courses listed below, at the Sunway Campus in Selangor only.

SUNWAY COLLEGE
Certificate in Finance, Accounting & Business
Certified Accounting Technician
Association of Chartered Certified Accountants
SUNWAY UNIVERSITY

BSc (Hons) in Computer Science / Information Technology/ Information Systems

(Progression from Dip in I.T.)
BSc (Hons) in Business Management/ Business Studies
(Progression from Dip in Bus Admin)
Diploma in Business Administration
Diploma in Hotel Management
Diploma in Events Management
Diploma in Culinary Arts
Diploma in Information Technology
Diploma in Interior Design
Diploma in Graphic & Multimedia

Your results MUST meet the course requirements of the college / university applied for.
ECEF will not consider applicants who have already commenced their courses.

State your choice : You MUST fill in this section. Your application will not be considered if
you leave this part blank. (Enclose copy of offer letter, if any.)

Course
Intake Date Duration Total Fees

If you have a second choice, fill in this part.

Course
Intake Date Duration Total Fees

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 SECTION D : CO-CURRICULAR ACTIVITIES (List top 5 since Form 3)

Activities in School/College Year Position Held

SECTION E : PRIZES / AWARDS RECEIVED (List top 5 only and enclose relevant certificates)

Description of Prizes / Awards Received Placing Year

SECTION F : MAJOR HOUSEHOLD EXPENDITURE (per month)

Your home is a) owned by your parents Yes / No Housing Loan Instalment per month : RM __________
Loan Balance Outstanding : RM_______________
b) owned by a relative Yes / No Who is this relative ? _______________________
c) rented Yes / No Rental per month : RM _____________________

Household cars: No. of cars ______Total amount of instalments per month for car loans : RM___________

Siblings Who Are Currently Studying

Name Age (M/F) Name of School/College Source of Support

Family Members With Special Needs

Name Age (M/F) Special Needs

Other Expenditure :

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SECTION G : HOUSEHOLD INCOME

Father/ Guardians Name Mothers Name

Highest Education level Age Highest Education level Age:

Occupation: Income/month (RM): Occupation: Income/month (RM):

Name & Address of Employer/own business Name & Address of Employer/own business

Siblings Who Are Working

Gender Income per Monthly
Name Age Occupation Name of Company month contribution
(M/F)
(RM) to family

Any Other Household Income Amount per Amount

(Eg. Pension, Rental, Part-time Business) month (RM) per month
(RM)
1. 5.
2. 6.
3. 7.
4. 8.

Enclose the following financial documents :

Parents or main household earners a. LATEST Income Tax Statement
b. 3 consecutive months salary slips
c. Current year EPF Statement
d. Any other proof of income

If your father / mother are retired,

a. Please state their professions and last positions held prior to retirement in the boxes above. Indicate
that they are retired and state the year of retirement. Write their last drawn salary in Income box.
b. Enclose their latest Income Tax Statements
c. Enclose their Income Tax Statements for the last 2 years of their working life.
d. Enclose current year EPF Statement.

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SECTION H: APPLICANTS WORKING EXPERIENCE (If any)

Place of Work Job Title & Pay Year Duration

SECTION I: REFEREE (NOT RELATED TO APPLICANT)

Name of referee
Position/Title
Place of Work
Contact (Mobile) (Office)
(Email)

SECTION J: PERSONAL STATEMENT

Write an essay in English on a separate sheet of paper (staple it to this application) to tell us in not
more than 500 words WHY I NEED THIS SCHOLARSHIP. You must use your own words. Do not copy
from any person or any book, magazine, newspaper, the internet, etc. Any form of plagiarism will
automatically disqualify this application.
Your essay MUST cover the following areas:

o A brief background of your family.

o If you live in a Childrens Home, please inform us here and give us a supporting letter
from the Home.
o How your academic achievements and co-curricular involvement have contributed to
your personal development.
o Why you chose to apply for the course(s) stated in Section C.
o Your future goals/dreams that you wish to be realized.
o Any other information that may support your application.

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SECTION K: DECLARATION

I have read the Personal Data Protection Notice provided by Sunway College/Sunway University pursuant to
section 7 of Personal Data Protection Act 2010 (http://sunway.edu.my/pdpa/notice_english), which
includes the purposes for which my personal data is collected/processed and classes of third parties to
whom Sunway College/Sunway University may disclose my personal data.
I hereby give consent to Sunway College/Sunway University to process my personal data in accordance with
the Personal Data Protection Notice.
I also hereby warrant that I have obtained all necessary consent from the third party where I have provided
their personal information as part of my application (such as information relating to my parents).
I consent to any educational institution at which I have previously been a student and/or my current or any
past employer, providing Sunway College/Sunway University with information which they hold about me
for the purpose of Sunway College/Sunway University verifying my grades and/or qualifications and
experience.
I authorise Sunway College/Sunway University to release fee and academic progress information to co-
sponsor of this scholarship (if any).

I declare that the information contained in this application form and in the attached documents is true and
accurate to the best of my knowledge. I also declare that I am not a member of the immediate family of
any Director of BBGS Alumni Berhad or of any member of the Selection Committee of the ELENA COOKE
EDUCATION FUND or of any staff of BBGS Alumni Berhad. I acknowledge that the SUNWAY EDUCATION
GROUP ELENA COOKE EDUCATION FUND reserves the right to seek from other relevant parties
verification as to the contents of my application. I further acknowledge that the SUNWAY EDUCATION
GROUP ELENA COOKE EDUCATION FUND reserves the right to vary or reverse any decision made on the
basis of false, incorrect or incomplete information, including the right to terminate the scholarship, in which
event I will be liable to repay the SUNWAY EDUCATION GROUP ELENA COOKE EDUCATION FUND the total
sum of any payments already received.

____________________________ _________________________________________ _______________

Applicants Signature Name Date

SECTION L: DECLARATION - PARENT/GUARDIAN

I have read the Personal Data Protection Notice provided by Sunway College/Sunway University pursuant to
section 7 of Personal Data Protection Act 2010 (http://sunway.edu.my/pdpa/notice_english), which
includes purposes for which my/the applicants personal data is collected/processed and classes of third
parties to whom Sunway College/Sunway University will/may disclose my/the applicants personal data.
I hereby give consent to Sunway College/Sunway University to process my/the appllcants personal data in
accordance with the Personal Data Protection Notice. I also confirm that I consent to the applicant applying
for the course(s) stated above and I will ensure he/she will attend an interview in the Klang Valley if short-
listed.

____________________________ _________________________________________ _______________

Parent/Guardians Signature Name Date