EPD Online Application Form |

EPD Online Application Form

All fields are compulsory. Application deadline: 25 November 2016

1. Participant Details

Salutation:

If others, please specify:

First Name:

Last Name:

Designation:

Department:

Organisation:

Address of Organisation:

Nationality:

No. of years related experience:

Office Number:

Mobile Number:

Email Address:

Dietary Restrictions (if any):


2. Programme Expectations

Kindly complete all the following questions. If space is not sufficient, please send your answers to .

What is your current role and what are your responsibilities?

In your view, what are some of the main obstacles and challenges that you face at work?

What do you hope to learn from the course?

Briefly describe one change that you would like to see implemented in your organisation.


3. Payment Details

Cost of Programme

S$4,750* + 7% GST
S$4,275* + 7% GST (for group registrations of 3 or more)

* Fee is based on per-person basis and includes food, refreshment and learning support materials. Overseas participants should arrange their own visa, travel costs from Singapore, accommodation, transport and cover their living expenses while in Singapore. The LKY School does not provide scholarships or financial aid for this programme.

*Goods and Services Tax (GST) is applicable for Singapore-based participants or overseas participants who are self-funded or sponsored by Singapore organisations.

Mode of Payment:

Sponsored by:

SUB-BU Code (only if sponsored by Singapore Government Agencies):

Payment Contact:

First Name:

Last Name:

Designation:

Department:

Organisation:

Billing Address:

Office Number:

Mobile Number:

Email:

Important Note:

Kindly complete the Application Form and submit together with a copy of the participant’s CV (file size limit 2MB). Applications will be prioritized on a first come, first served basis. LKY School reserves the right to accept or reject applications.

Submit digital copy of CV (file size limit: 2MB):


4. Cancellation Policy

Once confirmed, should the participant cancel four (4) weeks before the programme, the LKY School will charge the participant or the sponsoring organisation a cancellation fee equivalent to 50% of the course fee. LKY School reserves the right to postpone or cancel the programme by giving at least 14 days notice.

I have read the cancellation policy and accept its terms


5. Additional Information

How did you hear about this course? (You may select more than one option)

Previous LKY School Executive Education programme participantLKY School AlumniLKY School WebsiteLKY School EmailLKY School NewsletterProgramme BrochureInternet SearchLKY School TwitterLKY School FacebookOthers; (Please specify:)

Please indicate below if and how you wish to be contacted about programmes and exclusive events from LKY School in the future. (You may select more than one option)

Phone numberMobile NumberEmailPostNo, I do not wish to be contacted

LKY School will use the above information to contact you regarding the programme. We will not share any of your personal information without your written consent.

Please note that photography, audio and video recording may occur during the programme. All photography, audio and video recording may be used by National University of Singapore (NUS) for education, marketing, promotional and/or publication purposes. If you do not wish to have your image recorded or published for this programme please inform us via email before the beginning of the course.


6. Form Submission

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