CATEGORY of STUDENT

International Student

Singaporean

Permanent Resident

Employment Pass

Work Permit

Dependent Pass

Student Pass Holder

Immigration Exemption

Long Term Social Visit Pass

S Pass

Social Visit Pass

Others

APPLICANT DETAILS

Surname/Family Name

First/Given Name (s)

Date of Birth (dd/mm/yy)

Nationality

NRIC (If Applicable)

Passport No.

Country of Issue

Issued Date

Expiry Date

Permanent Home Address

Block No./House No.

Street

City/Town

Postcode/Zipcode

Country

Email Address

Tel. No.

Mobile No.

PROGRAMME APPLIED FOR

Course Name

Mode of Study

Full Time

Part Time

Intake (if you are not aware, please contact Amity's Marketing department)

Year

Month

HOW DID YOU COME TO KNOW ABOUT AMITY GLOBAL INSTITUTE ? (Choose only one)

Source

Referral

Agent

Others

EDUCATION RECORDS (Please attach all Certificates & Transcripts)

Name of School/University	City/Country	Qualification Awarded

AWARDS/ACHIEVEMENTS, IF ANY (At least 2)

Name of Award	City/Country	Qualification Awarded

CONDUCT

Have you ever been suspended, dismissed or put on academic probation or warning at any school or college?

Yes

No

If 'Yes' please explain on the text box

ENGLISH

If applicants first language and/or education is not in English, please enclose copies of English language proficiency as required and tick the appropriate level.

IELTS

TOEFL

Others
(Please Specify)

EMPLOYMENT HISTORY (If applicable)

Work Experience

Yes

No

If 'Yes', please indicate the total numbers of year/month

Year

Month

Details of current / last job

Organization Name

Address of Organization

City

Tel. No

From

To

Full Time

Part Time

Designation

PERSONAL STATEMENT

(Please give reasons for choosing this programme of study. You may attach further sheets).

FOR EMERGENCY CONTACT DETAILS

Person to be contacted (Full Name)

Relationship

NRIC/FIN/Paspport No.

Handphone No.

E-mail address

CHECK LIST

Course Application Fees

Completed Application Form

Copy of Passport/NRIC

Copies of Educational Certificates and Transcripts

Work Experiences Testimonials

Four Passport Size Photographs

Resume

PERSONAL DATA PROTECTION ACT – CONSENT FORM

In compliance with the Personal Data Protection Act (“PDPA”), AGI seeks your consent to collect and use your personal data (ie. Name/Passport number, contact numbers, mailing and email addresses) in order to maintain the student enrolment registers and to disclose such personal data to the relevant educational authorities where necessary.
AGI will also collect and use your personal data to provide you with information on our activities such as upcoming events, seminars, workshops, conferences and training programmes organised by AGI and its affiliated organisations which may be relevant to you.
AGI respects your privacy and assures that your personal data will be kept securely according to PDPA.

I hereby give my acknowledgment and consent to AGI to use my personal data for the aforesaid Purposes and Services. In the event that I have registered my Singapore telephone numbers with the Do Not Call Registry and wish to withhold or withdraw my consent to AGI in respect of receiving telephone calls/or SMS, I endeavor to provide sufficient notice in writing.

I agree that my consent will remain in place until my withdrawal by officially notifying AGI in writing.

WAIVER & INDEMNITY

1.	I wish to participate in the Activities / Events organised by Amity Global Institute and/or it’s Agent/s.
2.	I warrant that I am in good health and have no physical condition that would endanger my life while participating in the Activities / Events.
3.	Whilst reasonable precaution will be taken by Amity Global Institute and/or its agent/s to ensure the safety of participants, I understand that I take part in the Activities / Events as a participant at my own risk. I confirm and agree that Amity Global Institute and/or its agent/s will not be held liable by me for any personal injury or death arising from my participation in the Activities / Events or for any loss of or damage to my property arising from my participation in the Activities / Events except for such injury or death that is caused directly by Amity Global Institute’s or its agent/s’ gross negligence.
4.	In consideration of Amity Global Institute allowing me to participate in the Activities / Events, I undertake that if, in the course of the Activities / Events, I deliberately or negligently cause any injury (whether fatal or otherwise) to any person or any damage to or loss of any property of any person, I shall indemnify Amity Global Institute if that suffering person makes claims or takes actions against Amity Global Institute has to pay for costs or expenses.

I acknowledge and undertake the Waiver & Indemnity as stipulated above.

I agree that my consent will remain in place until my withdrawal by officially notifying AGI in writing.

INTERNATIONAL STUDENT DECLARATION

APPLICABLE [If you are an international student, please acknowledge the following]	NOT APPLICABLE [If you are not an international student, please skip this section]
1.	I declare that I will not be engaged in any form of employment or attend an industrial attachment/internship programme, whether paid or unpaid, without a valid work pass issued by Ministry of Manpower. (Employment of Foreign Manpower Act (Cap. 91A))
2.	I declare that I will not be overstaying or working illegally in Singapore which is a serious offence and on conviction, the penalties may include mandatory imprisonment and caning.
3.	I declare that I will be fulfilling the attendance requirements. I am aware of the following Attendance Requirements. International Student: If International Student fails to meet either of the below requirement without valid reason, he/she will be dismissed from the course and the Student Pass will be cancelled. International Student will have to meet at least 90% monthly attendance rate Attend class for a continuous period of seven days or more Further for international students on student’s pass, 90% attendance is required in order to be eligible to sit for examinations/ assessments. Failing which the student will also be barred from the examinations / assessments of the module concerned. Further the student needs to repeat the entire module with attendance and payment of the relevant fees.
I acknowledge and undertake the International Student Declaration as stipulated above

PRE-COURSE COUNSELLING FORM

DECLARATION

I confirm that all information given by me in this application is true, complete and correct. I understand that my application or any subsequent offer may be withdrawn by Amity Global Institute if in the future, the information provided proves to be inaccurate, either intentionally or unintentionally. I hereby also authorize the institute to conduct enquiry or investigation of the above information for the purpose of verification. In addition, I have read, understood and accept the School Fees, charges and Refund Policy as given in website (http://www.amitysingapore.sg). While I am a student, I shall abide by all the rules of the School.

I authorize Amity Global Institute to authenticate the certificate(s)/record(s) that I have provided to the institute during the admission/enrolment into the programme. I release all persons from liability on account of such disclosure.

All students enrolled with the University of Northampton need to agree to the following Terms and Conditions. Please take the time to read the information in the website.

CONFIDENTIALITY CLAUSE

Amity Global Institute shall treat the student’s information as a highly confidential property of the school and will not disclose any information to any third party without the written consent of the student in this agreement.

Amity Global Institute shall only store necessary and limited information pertaining to the student’s attendance such as the student’s NRIC/FIN No., ID Number, Name and fingerprints (not as images but in alpha-numeric code).

From day to day, Amity Global Institute shall only store IN and OUT timings, class schedule timings, leaves, withdrawals and all other related activity scheduled information.

After the student has graduated and/or left Amity Global Institute all data and information pertaining to the student will be erased, deleted and destroyed by the school’s biometrics system.

The student has been briefed on the following items: Note to student: Please indicate with Yes the items that you have been briefed on and with ‘N.A.’s the items that are not applicable to you
Yes N.A	Amity Global Institute’s locations, facilities & infrastructure
Yes N.A	All fees payable throughout the student’s duration of study, all payment modes accepted by Amity Global Institute and any payment schedules
Yes N.A	The necessity for the student to sign the Advisory Note to Students and Private Education Institution-Student Contract before proceeding to make payment for fees to Amity Global Institute.
Yes N.A	The fee protection insurance scheme adopted by Amity Global Institute
Yes N.A	Any clauses that may be in the Private Education Institution-Student Contract
Yes N.A	Amity Global Institute’s transfer, withdrawal, deferment and refund polices
Yes N.A	The Student Support services offered by Amity Global Institute (E.g. counselling)
Yes N.A	The entry requirements for the course(s) that is/ are of interest to the student, any possible exemptions for the course(s) that is/ are of interest to the student and the process by which the student might apply for his/ her chosen course
Yes N.A	The outlines of the course(s) that is/ are of interest to the student and their respective modules
Yes N.A	The suitability of the course(s) that is/ are of interest to the student with the student’s aspirations
Yes N.A	The durations of and assessment schedules for the course(s) that is/ are of interest to the student
Yes N.A	Amity Global Institute’s attendance policy
Yes N.A	The promotion and award criteria of the course(s) that is/ are of interest to the student and any special conditions for the same
Yes N.A	The type of certification that will be awarded at the end of the course(s) that is/ are of interest to the student
Yes N.A	Any opportunities for the student to pursue further education after graduation from Amity Global Institute and the job prospects of studying at Amity Global Institute
Yes N.A	The Committee for Private Education’s official website, www.ssg.gov.sg
Yes N.A	Amity Global Institute's Medical Insurance Scheme and Policy (to opt-out if applicable)
	For International Students
Yes N.A	The requirements and procedures for Student’s Pass application
Yes N.A	The fact that Student’s Pass holders are not permitted to engage in any form of employment or attend any industrial attachment/internship programme, whether paid or unpaid, without a valid work pass issued by the Ministry of Manpower
Yes N.A	Other relevant Singapore laws (E.g. Immigration requirements, Laws on driving, drugs and alcohol abuse, employment, smoking, traffic and littering, etc.)
Yes N.A	Life in Singapore (Accommodation, Cost of living, etc.)

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