Application for Asian Nursing Scholarship ( ANS )
ANS Registration Form
Sign in to Google to save your progress. Learn more
1. Full Name (As in IC) *
(Example: Lee Mei Mei)
2. New IC Number *
(Example: 051225-01-5852)
3. DOB (dd-mmm-yyyy) *
(Example: 25-Dec-2005)
4. Gender (Female/Male) *
5. Nationality *
6. Dietary Requirement *
7. Valid Handphone Number (Include Country Code) *
(Example: 60123358992)
8. Home Address (Full Address same as MyKad) *
9. Valid Personal Email Address (Gmail only) *
(Note: Create a Gmail address which is easier to identify, example: leemeimei05@gmail.com)
10. Name of Next-of-Kin (NOK) *
(Name of Father or Mother)
11. Relationship of NOK *
12. Contact Number of NOK *
(Example: 60123358992)
13. Highest Qualification (e.g Degree /  Diploma / STPM/ SPM / UEC). <Tick SPM if you are doing SPM this year> *
14. Year of SPM/UEC/GCE O-Level obtained. <You can proceed to apply if you are doing SPM this year, once your trial exam "PERCUBAAN" result is available, you can email us later in Nov/Dec> *
( Example: 2022, 2021, 2020, 2019...)
15. Height (unit in meter) *
(Example: 1.65)
16. Weight (unit in kilogram) *
(Example: 54)
17. Race *
18. Religion *
19. Name of School *
(Example: SMK Ulu Tiram)
20. Any medical condition? or on long-term medication? (example. Thyroid? Asthma? Diabetes? Hypertension? Scoliosis? Implant? ​​Thalassemia? Any surgery? Color-blindness?) Also, please declare if you have Visible Tattoo/Body Art. *
21. Please note down the below email address and email your UEC/SPM Certificate/Current Year SPM Trial Result (PERCUBAAN) to : *
22. Are you a Singapore PR (Singapore Permanent Resident) ? *
23. How do you get to know ANS? (our iHR Facebook? our iHR ANS Facebook Page? through Sister?/ Brother?/ Cousin?/ Friend/ Senior/ Teacher?) . Have you contacted anyone else to apply this ANS? What is their name? *
24. Any sibling is applying or currently in ANS? *
25. Which location will you choose to attend interview if you are eligible for ANS interview? *
26. Is your daily activity movement affected by any of your imperfection/impairment of your not fully functional limps(legs/hands)/arms/fingers? or you cannot squad or bend down? or your body weight has affected your walking gait? *
Consent Clause: By submitting this Form, you hereby agree that the International Human Resources Services Pte Ltd (iHR) may collect, use and disclose your personal data that you provide in this Form for the purpose of sending you updates about the various events, job applications, seminars and related activities organized or co-organized by iHR. You also consent to the disclosure of your personal data to iHR clients/partners/affiliates and other third-party service providers that iHR may engage from time to time. iHR respects the privacy of individuals and recognizes the importance of the personal data you have entrusted to us and believe that it is our responsibility to properly manage, protect, process and disclose your personal data. *
Required
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms