ROHAS-EUCO EDUCATION FUND

Application Form For Scholarship

For Academic Year _________

Attach Recent Photograph Here

Please read the application procedures, the terms and conditions at the back of the page before completing the same. Courses Applied For/Course enrolled currently Application Procedures: Name of University/College

Ref:

Print clearly or write legibly. False particulars or wilful suppression of material facts will render you liable to disqualification. All required documents must be submitted with the application. Closing date is as advertised. Applications received after the closing date will not be entertained. Application must be submitted in sealed envelopes and marked Scholarship on the TOP LEFT HAND CORNER. Note: Proof of posting is not proof of receipt. Address application form to: The Administrator Rohas-Euco Education Fund Rohas-Euco Group of Companies 2nd Floor, Rumah Rohas, No. 61, Jalan Raja Abdullah, Kampung Baru, 50300 Kuala Lumpur. Applicants must meet the following general conditions: Malaysian citizens below 25 years of age as on 1st January this year. Possess good results in SPM/STPM or other equivalent qualifications. Be active in sports and extra-curricular activities. Must not be bonded by any other educational institutions or organisations. Must be able to gain admission to approved university or college or currently enrolled in the first year of study.

Section A
Full Name (as in NRIC):

Personal Details

Residential Address: .. Post Code: House Tel : Handphone No: Email: . Nationality: Date of Birth: / ..../ .. Race: Sex: Religion:

* Male

* Female
Languages:

Identify Card No. (Old): (New):

.. ..

Marital Status:

* Single

* Married

Spoken:

Written:

For Office Use

Date of Interview: Remarks:

Recommended for Scholarship:

* Yes

* No

_________________________________________ Signature of Head of Human Resource Division Date:

Section B
Name and Address of School:

Educational Qualifications SPM/SPVM Examination Results

Year Taken:

Overall Grade:

Aggregate:

Tel: Subject Grade Subject Grade

STPM/"A" Level Examination Results

Name and Address of School: Name of Examination:

Tel: Year taken: Subject Overall Grade: Grade Subject Aggrerate/CGPA: Grade

Other Qualifications/ Awards

Date: Name of Examination / Award Grade / Award

Section C
Name and Address of Employer

Working Experience (if any)

Designation Period

Section D

Extra-curricular Activities

Details of extra-curricular activities, including membership of societies/ associations. (You may use separate sheet of paper)

Section E

Medical Condition

State present health condition and give details of any ilness or disability that requires attention:

Section F

Reason(s) for Application

State briefly your reason(s) for applying this scholarship: (You may use a separate sheet of paper)

Section G
Name: Home Address:

Family Background Father

Age: NRIC No: House: Family Owned Rented

Tel: Name and Address of Employer Occupation:

Tel:

Mother
Name: Name and Address of Employer: Age: NRIC No: Occupation:

Tel:

Guardian (if applicable)

Name: Name and Address of Employer: Age: NRIC No: Occupation:

Tel: If parents/guardian are self-employed: Name and Address of Business: Nature of Business: Length of Establishment of Business: ...month(s)...years(s) If partnership or joint venture, state share held by parents/guardian.

Tel: Is the business wholly-owned? Yes No

Annual Gross Income of Parents / Gurrdian (Last Year) Father (RM) Employment Business Rental Others Total Family Expenditures Type of Expenditures House Installments/ Rental Electricity & Water Telephone &/ or Handphone &/or Internet Loan Repayment (car/ motor-bike/ appliances) Transport Education Others Total Names and Particulars of Siblings/ Other Dependents Name: Relationship Age Marital Status Occupation Annual Income (RM) Monthly (RM) Yearly (RM) Mother (RM) Guardian (RM) Total (RM)

Section H
Name: (Dr./Mr./Mrs./Ms)

References
Name: (Dr./Mr./Mrs./Ms)

Give names, addresses and occupations of two (2) referees (not related to the applicant)

Address:

Address:

Tel No: Handphone No: Email: Occupation:

Tel No: Handphone No: Email: Occupation:

Relationship:

Relationship:

TERMS AND CONDITIONS

Tenure of Scholarship The scholarships are tenable for the minimum period required by the recipients to complete the first degree up to a maximum period is four (4) years.

4 Period of Training/Attachment: During the scheduled vacation, term or semester breaks, the recipient may request the Group and the Group may accommodate such request for a period of training or attachment with the Group for which an allowance will be paid by the Group. Such training or attachment shall NOT be deemed to be part of the period of bond nor shall the recipient be deemed as an employee of the Group.

Disbursements of Awards: The scholarships shall be disbursed on per semester/term basis and shall be paid directly to the institutions except the living expenses. This amount covers registration/course/tution fees and living expenses. 5 Liquidated Damages/Penalties for Non-fulfillment of Conditions by Recipients: Conditions of Awarding the Scholarships Recipients of scholarships awarded by Rohas-Euco Group of Companies (Group) are required to enter into an agreement with the Group on the following conditions: i. The Group reserves the right to take appropriate action(s) against any recipient who may have successfully completed his/her studies and who fails to comply with the conditions as stipulated in clause 3 above.

a/

b/

c/

ii. A bond can be repudiated in writing by the recipient upon his/her completion of The recipient shall become and during his/her tenure thereof shall remain a study. And in this case, a penalty/liquidated damages shall be levied by the Group student at the place of education/training and shall pursue his/her studies and the recipient shall pay within the stipulated time frame. In the event that the diligently and to the satisfaction of the Group. recipient is unable to make good the payment within the stipulated period, he/she If any recipient commits a breach of any of the conditions laid down by the may be allowed (subject to the Groups discretion) to settle such payment by Group or in any way whatsoever misconducts himself/ herself, he/she may monthly installments to be decided by the Group. The penalty/ liquidated damages thereupon be deprived of such award. Where an award is withdrawn due to for repudiating such bond shall be to the full amount of the scholarship and any breach of conditions or misconduct of the recipient, any sum paid or including any incidental cost in granting the scholarship. disbursed for the benefit of the recipient shall be recoverable from the recipient plus interest at a rate of twenty per cent (20%) per annum. In addition, appropriate legal actions may be initiated and all costs thereby 6 Waiving of Penalty/Liquidated Damages: incurred shall be borne by the recipient. A waiver shall be deemed to have been granted if the recipient does not receive an offer of employment from the Group within three (3) months after completion of All recipients will be required to enter into a service bond with the Group his/her studies, PROVIDED that the recipient has taken reasonable steps to inform unless waived by the Group. The service bond will include the following: the Group of such completion of his/her studies three (3) months before the completion. the period of bond shall be on a one (1) for one (1) year basis. 7 Termination of Award:

i. ii. iii.

the bond shall be effective within three (3) months after the completion of the i. The Group reserves the right to withdraw, terminate or vary the scholarship offered recipients studies. to the recipient who: in the event that the Group does not require the service of the recipient upon completion of his/her studies, the Group shall release the recipient from the bond without cost to the recipient. bonding does not mean that the Group is obliged or committed to offer temporary or permanent or any employment with the Group. during the period of bond the remuneration for the recipient shall commensurate with the recipients qualification (s) and work experience (if any) and the Groups overall scheme of employee remuneration including benefits. This can not be reviewed by any court of law or tribunal save as provided in the Employment Act. in the course of service during the period of bond, the recipient shall observe all rules and regulations applicable to employees of the Group. a/ does not achieve satisfactory academic performance during the course of his/her studies, and/or, b/ commits a breach of any of the conditions laid down by the Group or in any way whatsoever misconducts himself/herself. ii. Such award can be withdrawn, terminated or varied prior to commencement or during the course of the prescribed studies. As stipulated in clause 3, any sum disbursed shall be recoverable.

iv. v.

vi.

vii. the recipient may be required to serve in any of the division, department or section or whichever location in Malaysia and overseas within the Group (including presently related or future companies) in a suitable capacity which shall be at the absolute discretion of the Group. viii. violation of any terms and conditions shall incur indemnity to Group of all or any sum advanced or expenses incurred up to the sum thereby incurred.