Scholarship
Pre-University Scholarship Form
Your Desired Scholarship Programme
PREFERRED FIELD OF STUDY*
PREFERRED UNIVERSITY*
*Disclaimer: The selection of field of study and university must correspond to the programme requirements within the Yayasan Sime Darby website.
FULL NAME (AS PER NRIC)
NEW NRIC NO.
Gender
AGE
Race
Marital Status
CONTACT DETAILS
MOBILE PHONE NO.
E-MAIL ADDRESS
LOCATION OF RESIDENCE
TOWN / CITY
STATE
Father / Guardian's Details
FULL NAME (AS PER NRIC)
NEW NRIC NO.
EMPLOYMENT STATUS
OCCUPATION
MONTHLY GROSS INCOME (RM)
MOBILE PHONE NO.
MOTHER / Guardian's Details
FULL NAME (AS PER NRIC)
NEW NRIC NO.
EMPLOYMENT STATUS
OCCUPATION
MONTHLY GROSS INCOME (RM)
MOBILE PHONE NO.
TRIAL SPM / LATEST EXAMINATION RESULTS
INSTITUTION / SCHOOL NAME
YEAR
No. OF A+
NO. OF A
MATHEMATICS RESULT
ADDITIONAL MATHEMATICS RESULT
MANDARIN RESULT (IF ANY)
ENGLISH PROFICIENCY
VERBAL
WRITTEN
MANDARIN PROFICIENCY
VERBAL
WRITTEN
NAME OF AWARD / ACHIEVEMENT / COMPETITION
YEAR
LEVEL
NAME OF CLUB / SOCIETY
YEAR
LEADERSHIP POSITION
Have you ever been charged or convicted for the violation of any law, excluding minor traffic offences?
Have you ever been charged of drug abuse or any other illegal substance under Malaysian law?
Are you diagnosed with any illnesses, diseases or disorders?
Please submit the following supporting documents:
  1. Photocopy IC of applicant,
  2. Copy of latest examination result,
  3. Father's / guardian's pay slip / income declaration / government pension's card,
  4. Mother's / guardian's pay slip / income declaration / government pension's card, and
  5. Parents' death / divorce certification (if any)
These documents should be combined in a single PDF file with a total size not exceeding 3MB.
SUPPORTING DOCUMENTS
**Personal Data Protection Act Disclaimer**

Your personal data will be processed in accordance with Personal Data Protection Act 2010. Please visit www.yayasansimedarby.com for more information. Thank you.

Data peribadi anda akan diproses mengikut Akta Perlindungan Data Peribadi 2010. Sila layari www.yayasansimedarby.com untuk maklumat lanjut. Terima kasih.
Thank You for Your Submission.
Rest assured that we will be in touch with you soon.
View Sitemap
© Copyright 2021 Yayasan Sime Darby 198201006191 (85945-W). All Rights Reserved.
Last Updated:
06 Apr 2021
Ooops!
Generic Popup