Online Application Form |

Online Application Form

All fields are compulsory. Application deadline: 15 April 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 Restriction (if any):


2. Programme Expectation

Motivation for joining the Programme (1 - 2 Sentences)

Describe your current role in your organisation (1 - 2 Sentences)


3. Payment Details

Singapore-based Participant: S$22,500 + 7% GST* (Without Accomodation)

Overseas-based Participant: S$28,500 nett (With Accomodation)
*Fee is based on per-person basis and does not include travel costs to/from Singapore to attend the programme. However, it include costs of travel, accommodation, travel insurance and meals associated with the one-week overseas component.

*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:

Please state the SUB-BU Code 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 and Passport Photo. Applications will be prioritized on a FRIST COME, FIRST SERVED basis. The LKY School reserves the right to determine the final list of participants taking diversity into account.

Please submit a copy of the participant’s CV (filesize limit: 2MB)

Please submit a copy of the participant’s Photo (JPG only, filesize 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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