Chili Padi Academy Application
All information provided in this form is strictly confidential. Please fill in the application form in English.
N.B: Application for Indonesian students has been CLOSED.
Full Name *
(as shown in passport)
Your answer
Preferred Name *
This is the name that you would like us to call you.
Your answer
Age in 2018 *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
What is your monthly household income per person in your family? *
This is the total income of all persons in the household divided by the total number of persons in your household. (Currency exchange: SGD1 = IDR9460) (Currency exchange: SGD1 = MYR3.10)
Gender *
Nationality *
Personal Contact Information
National ID Number *
Your answer
Email Address *
Your answer
Mobile Phone Number (With Country and Area Code) *
Your answer
Home Address *
Your answer
Postal Code *
Your answer
City or State *
Your answer
Name of School *
Your answer
Questions
Please list and briefly describe any leadership experiences or extra-curricular activities that you have been involved in, in school or in your community. *
Your answer
Please list any past achievements or awards that you have obtained.
Your answer
Describe your interests and how you've been engaging yourself in developing it. *
(max 200 words)
Your answer
Describe a problem in your community and what you would do to address or solve it. *
(max 200 words)
Your answer
What do you hope to achieve for yourself through this programme? *
(max 100 words)
Your answer
On a scale of 1 to 5, how comfortable are you sharing your personal experiences and forming new bonds with people that you've just met? *
Least Experienced
Most Experienced
Terms and Conditions
I declare that the information that I have entered above are all accurate and true. *
Required
I confirm that I can commit for all three months of Chili Padi Academy (May - Aug 2017) *
Required
I understand that if I am selected and decide to participate in the programme, my participation would require me to voluntarily take time off from my academic studies. Chili Padi Academy 2.0 will not approach my school on my behalf nor issue a letter of excuse. I understand that I will also have to fill in a parental consent form, health declaration form and indemnity form upon successful selection. *
Required
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