YAYASAN DAYADIRI 2022 PRE-UNIVERSITY SCHOLARSHIP PROGRAMME

2022 Pre-University Scholarship Application Form
Application Requirements
1. Must meet eligibility criteria
  - Malaysian Bumiputera (including Pribumi Sabah, Sarawak, and Orang Asli) whose total household income is not exceeding RM4,850 per month;
  - Minimum 7As (A and A+, including English and Mathematics) in Sijil Pelajaran Malaysia (SPM);
  - Strong in academics and extra co-curricular activities;
  - Fulfil other required personal traits and selection criteria.
2. Please complete ALL sections of the application form, including the minimum 200-word essay and signing the acknowledgement page by 30 June 2022.
3. Please upload ALL documents as required.
4. Please ensure that correct spelling, grammar, proper use of punctuation and capitalization is applied prior to application submission. Failure to do so may result in disqualification.
Documents Required
- Scanned copy of Passport Photo (please refer to guideline )
- Scanned copy of NRIC
- Scanned copy of Birth Certificate
- Scanned copy of offer letter from institution (for IBD at MCKK-IB or TKC-IB)
- Scanned copy of examination results slips (SPM/ PT3/ other related examinations)
- Scanned copy of verified Income Declaration documents ( 2022 most current e.g. 3-month Payslip/ EA form/ Income Declaration for those with no-income or no-payslip/ Surat Akuan Pendapatan untuk mereka yang tiada pendapatan atau tiada penyata gaji) for Father/ Guardian 1 *
- Scanned copy of verified Income Declaration documents ( 2022 most current e.g. 3-month Payslip/ EA form/ Income Declaration for those with no-income or no-payslip/ Surat Akuan Pendapatan untuk mereka yang tiada pendapatan atau tiada penyata gaji) for Mother/ Guardian 2 *
- Scanned copy of Father/ Guardian 1 OR Mother/ Guardian 2's Death Certificate (if applicable)
*Successfully shortlisted candidates will be notified and required to submit the verified hardcopy version to YDD prior to the Panel Interview (target date: August). Verification are to be done by any of the certifying officers e.g. employer/ school principal/ official head of village/ government officers (Grade 41 & above)/ justice of peace/ lawyers/ notary public/ commissioner of oaths/ court/ company secretary.

Notification of shortlisted candidates

Only successfully shortlisted candidates will be notified via email or phone within four weeks after the closing date of the application.

Personal Details
Name as per NRIC *

Your Name Bin/ Binti + Your Father's Name/ Surname
Please upload your Passport Photo here *

Document format in jpg, png, or gif only
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NRIC No *
Numbers only, please do not include any symbol character (e.g. "-")
Please upload a copy of your NRIC here *

Document format in pdf, doc, docx, jpg, png, or gif only
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Please upload a copy of your Birth Certificate here *

Document format in pdf, doc, docx, jpg, png, or gif only
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Date of Birth *

Day Month Year
Gender *

Male Female
Address *

House Number Street address

Street Address Line 2

City State

Postcode
Ethnicity *
If Other, please specify
Contact Number *

Country Code Phone Number
Email *
example@example.com
Institution : Programme *

Please upload your Offer Letter here *

Document format in pdf, jpg, png, or gif only
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Education

School and Qualification *

	Institution Name	Year	Financial Aid (include sponsorship body’s name and amount if applicable)
SPM or equivalent
PT3 or equivalent
UPSR or equivalent

Qualification: SPM or equivalent *

	Subject	Grade
1
2
3
4
5
6
7
8
9
10
11

Please upload your SPM or equivalent results slip here *

Document format in pdf, jpg, png, or gif only
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Qualification: PT3 or equivalent *

	Subject	Grade
1
2
3
4
5
6
7
8

Please upload your PT3 or equivalent results slip here *

Document format in pdf, jpg, png, or gif only
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Extra Co-curricular Activities

Up to 6 activities, additional activities can be uploaded in a separate document *

	Activity/ Programme	Organisation	Role and Responsibilities	Year
1
2
3
4
5
6

If applicable, please upload information on additional activities per above table here:

Document format in pdf, doc, docx, jpg, png, or gif only
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Family Details - Father/ Guardian 1
Father/ Guardian 1 Name *

Father's/ Guardian 1 Name Bin/ Binti Father's/ Guardian 1's Father's Name/ Surname
Father/ Guardian 1 NRIC No *
Please do not include any symbol character (e.g. "-")
Father/ Guardian 1 Contact Number *

Country Code Phone Number
Father/ Guardian 1 Email
example@example.com
Father/ Guardian 1 Highest Education Qualification *
Father/ Guardian 1 Status *
Relationship status with Mother/ Guardian 2
If Other, please specify
Father/ Guardian 1 Employment Status *
Father/ Guardian 1 Occupation *
Father/ Guardian 1 Company Name *
Father/ Guardian 1 Monthly Income (RM) *
Monthly income (if no income, please input 0)
If Father/ Guardian 1 is Unemployed/ Retired/ Other, why? *
Please explain Father/ Guardian 1 current situation
Father/ Guardian 1 Income Declaration Documents *

Document format in pdf, jpg, png, or gif only of 2022 most current 3-month Payslip/ EA Form/ Income Declaration for those with no-income or no-payslip/ Surat Akuan Pendapatan untuk mereka yang tiada pendapatan atau tiada penyata gaji
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Father/ Guardian 1 Death Certificate *

Document format in pdf, jpg, png, or gif only
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Family Details - Mother/ Guardian 2
Mother/ Guardian 2 Name *

Mother's/ Guardian 2 Name Bin/ Binti Mother's/ Guardian 2's Father's Name/ Surname
Mother/ Guardian 2 NRIC No *
Please do not include any symbol character (e.g. "-")
Mother/ Guardian 2 Contact Number *

Country Code Phone Number
Mother/ Guardian 2 Email
example@example.com
Mother/ Guardian 2 Highest Education Qualification *
Mother/ Guardian 2 Status *
Relationship status with Father/ Guardian 1
If Other, please specify
Mother/ Guardian 2 Employment Status *
Mother/ Guardian 2 Occupation *
Mother/ Guardian 2 Company Name
Mother/ Guardian 2 Monthly Income (RM) *
Monthly income (if no income, please input 0)
If Mother/ Guardian 2 is Unemployed/ Retired/ Other, why? *
Please explain Mother/ Guardian 2 current situation
Mother/ Guardian 2 Income Declaration Documents *

Document format in pdf, jpg, png, or gif only of 2022 most current 3-month Payslip/ EA Form/ Income Declaration for those with no-income or no-payslip/ Surat Akuan Pendapatan untuk mereka yang tiada pendapatan atau tiada penyata gaji
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Mother/ Guardian 2 Death Certificate *

Document format in pdf, jpg, png, or gif only
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Family Details - Siblings
Do you have any siblings? *

Yes No

Up to six siblings, additional siblings can be uploaded in a separate document

	Name	Age	Gender	School/ Employer and Occupation
1
2
4
4
5
6

If applicable, please upload information on additional siblings per above table here:

Document format in pdf, doc, docx, jpg, png, or gif only
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Personal Statement

Essay
Why do you think you deserve this scholarship, and how will your long term ambitions contribute to the development of Malaysia ? *

Minimum 200 words - 0/500

Acknowledgement
I hereby acknowledge that all information provided or shall be provided by me in this form or through any other supporting documents are true and accurate and Yayasan DayaDiri shall be at liberty to decline my application herewith if any information provided by me is found to be false and inaccurate.

I understand that as part of the scholarship application process, Yayasan DayaDiri may conduct a background check on me. As such, I hereby authorize Yayasan DayaDiri and its representatives to obtain relevant information pertaining to myself from any party who has information about me.

It is expressly understood that any information given by any party mentioned above is to be used solely for the purpose of my scholarship application to Yayasan DayaDiri. I shall release all parties who have provided information for the purpose of my background checking from any liability.

Should I be offered a scholarship from Yayasan DayaDiri, I hereby agree to extend my consent and agreement contained herein for the period that I remain a scholarship recipient of Yayasan DayaDiri.

This form may be reproduced in Portable Document Format (PDF), photocopied or facsimile, and the reproduced form shall be binding on me as the original.

By signing below, I hereby acknowledge that I have read, understood, and agree to the above statement(s).
Applicant *

Clear
Father/ Guardian 1 *

Clear
Mother/ Guardian 2 *

Clear
Should be Empty:

2022 Pre-University Scholarship Application Form

Application Requirements

Documents Required

Notification of shortlisted candidates

Personal Details

Education

Extra Co-curricular Activities

Family Details - Father/ Guardian 1

Family Details - Mother/ Guardian 2

Family Details - Siblings

Personal Statement

Acknowledgement