This form is applicable for International Students DATE OF TEST: with: PACT Application Form 1.

Dependents Pass ( DP), or 2. Immigration Exemption Order (IEO), or 3. Either parent who is a Singapore Citizen (SC) or Singapore Permanent Resident (SPR).
Please contact PAI at (65) 6363 0330 for available test date.
Note: International Students who does not fall under the above mention categories may wish to visit the Ministry of Education website at www.moe.gov.sg or Tel (65) 6872-2220 for information on Admission Exercise for International Students (AEIS). *All fields are mandatory and must be completed in English in clear BLOCK LETTERS (with exception of the email address).

PART A: Candidate Particulars

*Name:
[as in passport]

*Passport No. /Birth Cert No:

(DD/MM/YYYY) D D st(as at 1 January)

#Gender : Male Female *Date of Birth: Y *Age: *Nationality:

MMYYY

*Country: Please affix a recent passport size photograph

#Please tick () in the appropriate box.

PART B: Level Applying For (Age as at 1s t

Photographs m more than 6 m

Jan uar y of adm issi on of aca dem ic year )

Note: If the age exceeds the age range of a particular level the applicant may have admission difficulty. Primary 2 (Age 7-9) Primary 3 (Age 8-10) Primary 4 (Age 9-11) Primary 5 (Age 10-12) Secondary 1 (Age 12-14) Secondary 2 (Age 13-15) Secondary 3 (Age 14-16)

The AFFIDAVIT DECLARATION overleaf forms part of this application. Please ensure that it is signed.

PART C: Representative / Contact Person Particulars

*Name :

*Mailing Address: [Please ensure accuracy as all correspondence and test result will be Relationship with Candidate: Parent / Guardian send to this address] / Agent / Other: *NRIC/Passport Number : *Contact Number:

FOR OFFICIAL USE ONLY

*Email Address:
Principals Academy, 9 Woodlands Ave 9, Republic Polytechnic, Singapore 738964 Tel: (65) 6363-0330

Payment Method: Cash Cheque No: Receipt No: Date:

Fax: (65) 6363-0220 Website: http://www.pact.sg

PART D : Affidavit Declaration

1) I declare that I am the parent/guardian/agent of the mentioned candidate and that all the information provided on this form is complete, true and accurate. I understand that any false information furnished in this form will render application and any related results in valid. 2) I ascertain t h e Date of Test a n d t h e L e v e l Ap p l y i n g F o r entered in this form are Correct. No amendments will be made after the submission of this application. Test fee is non-refundable. 3) I understand that if this Application Form is not duly signed and completed, the application is considered null and will be voided. 4) I undertake to ensure that the candidate mentioned will present both his/her Original Passport & Official Receipt on the test day. I understand that the candidate will be prohibited from sitting the test without the mentioned documents. 5) I acknowledge that any attempts to cheat, copy the work of another candidate, disrupt the test, removes or copies any test materials from the examination hall or perform any action that compromises the integrity of PACT will render the applying c a n d i d a t e s r e s u l t i n v a l id. 6) I hereby agree to: 6.1 The collation of information in this application form for the purpose of test administration. 6.2 The disclosure, processing and storage of information in this application by the respective participating Singapore government schools for admission purposes. 6.3 The disclosure of the s tu d e n t s r e s u l t and particulars upon request of verification by any academic institution or authorized education entity that the student has submitted an enrolment application for. 6.4 The voiding of any falsified or altered PACT Result Statement used for the admission to any academic institutions or entities, t h e s u b m i s s i o n o f t h e a p p l i c a n t s p a r t i c u l a r s to the relevant authorities for disciplinary action and the disqualification of the candidate from taking of any PACT examination in the future. 7) I understand that results will be posted to the mailing address within one month from the date of test. 8) I shall not hold Principals Academy and any other party involved in creating, producing, or delivering PACT liable for any direct, indirect, incidental, consequential, special, punitive, or similar damages arising out of access to, use of, acceptance by, or interpretation of the results by any third party, or any error or omission in the content thereof. 9) Principals Academy reserves the right to amend the information given in this Statement. E&OE. Pa ren t s/Gu ar d ian Parent/Guardian/Agent Name: s / Agen t s Signature: Pa ren t s/ Gu ar d ian s/ Agen t s NRIC/Passport No:

Dat

e:
Last updated: 22/12/2011
Tel: (65) 6363-0330 Fax: (65) 6363-0220

Principals Academy, 9 Woodlands Ave 9, Republic Polytechnic, Singapore 738964 Website: http://www.pact.sg

Check List
The following copy of the supporting documents must be submitted with the application form:

a) Application form b) 1 passport-size photograph (Note: The photo must not be more than 6 months old) c) Candidate s Dat a Page of t he Passport d) Candidate s Deed Poll (if any) e) Holder Pass / Official Document E.g. DP, IEO, SC, SPR d) Test Fee C Cash / Cheque / Bank-draft
If there is anything you do not understand, please contact Principals Academy Office at (65) 6363-0330 or email us your query: info@pai.sg or visit our website: www.pact.sg for more information.

Principals Academy, 9 Woodlands Ave 9, Republic Polytechnic, Singapore 738964 Website: http://www.pact.sg

Tel: (65) 6363-0330

Fax: (65) 6363-0220