Online Application Form |

Online Application Form

All fields are compulsory. Application deadline: 27 Jan 2017

1. Participant Details


If others, please specify:

First Name:

Last Name:




Address of Organisation:


Date of Birth (DD/MM/YYYY):

Office Number:

Mobile Number:

Email Address:

Dietary Restrictions (if any):

2. Programme Expectations

What is your motivation for joining the programme? (1 - 2 sentences)

Describe your current role in your organisation. (1 - 2 sentences)

3. Payment Details

Cost of Programme

S$2850 + 7% GST*
S$2,565 + 7% GST* (for group registrations of 3 and above)

*Fee is based on per-person basis and includes food, refreshments 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.

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

*Nominees from non-profit and non-governmental organisations may qualify for discounted rates. Please contact us for more details.

Mode of Payment:

Sponsored by:

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

Payment Contact:

First Name:

Last Name:




Billing Address:

Office Number:

Mobile Number:


Important Note:

Kindly complete the Application Form. Applications will be prioritized on a first come, first served basis. LKY School reserves the right to accept or reject applications.

4. Cancellation Policy

Once confirmed, should the participant cancel one (1) week 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

Key in the following CAPTCHA code before clicking on the "Submit" button.


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