Please enter the information in the form below to process course registration.

COURSE DATES :

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VENUE:

REGISTRATION TYPE *:

Company Sponsored Self Sponsored

Section A : Trainee Details

Trainee Name * :

ID Type * :

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ID No. * : Duplicated ID No..

Card Type * :

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Date of Birth * :

Age :

Contact Number * :

Email *email already exists :

Nationality * :

Race * : Please select an item in this field list.

Country of birth :* :

Gender * :
Male Female

Address :

Billing Address :

Postal Code :

Billing Postal Code : Same as Address

Apply Shepherd Bursary Award

Section B : Educational Backgroud

Highest Qualification *

Name Of institutions :

Name Of Qualification :

Year of completion :

Educational Certificate :

Note :File must be JPG, GIF ,PNG,PDF,Doc,Excel or BMP And Max Size 1 MB.

Passport Photo *

Note :File must be JPG, GIF ,PNG,PDF,Doc,Excel or BMP And Max Size 1 MB.

Supportive Document *

Note :File must be JPG, GIF ,PNG,PDF,Doc,Excel or BMP And Max Size 1 MB.

Section C : Emergency Contact

Emergency Name *

Relationship *

Emergency Email *

Emergency Mobile *

Section E : Employment Background

Employment Status *
Employed Full Time
Employed Part Time
Unemployed
Never worked

Employer Name *

Company Address *

Designation *

Salary Range *

Industry Sector *

Previous Industry Sector *

Section F : English Proficiency

Please select one of the following options:
English was the language of instruction in your previous studies
I complead an approved English language test(complete details below and ATTACH EVIDENCE)

Section G : Other Information

1. Are you a member of SCC? *
Yes No

2. Are you graduate of Singapore Counselling Centre? *
Yes No

Once you finish your training, would you like SINGAPORE COUNSELLING CENTRE to contact or email you to discuss how you can continue your learning journey at a higher level and what new courses are available? *
Yes No

Section H : Disability/ Special Needs

Do you have any disability / impairment / longterm medical conditions that may affect your studies? *
Yes No

Do you require any additional support in class/ examination due to the above condition? *
Yes No

Please attach the supporting document regarding your condition (e.g. Medical Support/ Memo from the doctor or relevant professional)

Note :File must be JPG, PNG or PDF, Size 1MB.

Section I : Special Schemas/ Waivers (If Applicable & Only One Scheme Applies)

Bring-a-friend Scheme *

Group Study Grant *

Progression Waiver

Other, please specify

SIGN by the Student

Clear Signature Confirm

-----------------------------------------------
Client Sign

Name:

NRIC/ Passport No:

Date:

Apply Training Grant :

Course Amount * :

Payment Method * :

Cheque No. * :

Upload File : * Support gif | jpg | png | jpeg

4.50% Processing Fees * :

Total Payable Amount * :

By registering for this course, I accept Terms and Conditions

Verification Code * :

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Existing Company New Company

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Section A : Trainee Details

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Section B : Educational Backgroud

Note :File must be JPG, GIF ,PNG,PDF,Doc,Excel or BMP And Max Size 1 MB.

Note :File must be JPG, GIF ,PNG,PDF,Doc,Excel or BMP And Max Size 1 MB.

Note :File must be JPG, GIF ,PNG,PDF,Doc,Excel or BMP And Max Size 1 MB.

Note :File must be JPG, GIF ,PNG,PDF,Doc,Excel or BMP And Max Size 1 MB.

Section C : Emergency Contact

Section E : Employment Background

Section F : English Proficiency

Section G : Other Information

Section H : Disability/ Special Needs

Note :File must be JPG, PNG or PDF, Size 1MB.

Section I : Special Schemas/ Waivers (If Applicable & Only One Scheme Applies)

Shepherd Bursary Award Application Form

Accessment Form For Non Diploma Holder

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Company Details

Section A : Trainee Details

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Section B : Educational Backgroud

Note :File must be JPG, GIF ,PNG,PDF,Doc,Excel or BMP And Max Size 1 MB.

Note :File must be JPG, GIF ,PNG,PDF,Doc,Excel or BMP And Max Size 1 MB.

Note :File must be JPG, GIF ,PNG,PDF,Doc,Excel or BMP And Max Size 1 MB.

Note :File must be JPG, GIF ,PNG,PDF,Doc,Excel or BMP And Max Size 1 MB.

Section C : Emergency Contact

Section E : Employment Background

Section F : English Proficiency

Section G : Other Information

Section H : Disability/ Special Needs

Note :File must be JPG, PNG or PDF, Size 1MB.

Section I : Special Schemas/ Waivers (If Applicable & Only One Scheme Applies)

Shepherd Bursary Award Application Form

Accessment Form For Non Diploma Holder

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