APPLICATION FOR MASTER POSITION (NUS HOSTELS) 1 PERSONAL PARTICULARS

1. PERSONAL PARTICULARS

Full Name (as in Passport/Identity Card)

Postal Address

Date of Birth

Country of Birth

Contact Number

Nationality

Race

Office:

Mobile:

NUS Email Address

Marital Status

Religion

No of children & their ages (if any)

Name of Spouse (if married) & Occupation

2. EDUCATION (Please state details of all academic and professional qualifications)

From

To

School/Institution/University

Country

3. EMPLOYMENT HISTORY (Please state history of employment after obtaining PhD)

From

To

Company

Position Held

4. CURRENT POSITION HELD IN THE UNIVERSITY

Designation (for example, Associate Professor, Professor)

Faculty/Department/Unit

(If joint appointment, please state percentage, for example, FOS 60% and FOE 40%)

Date of Appointment to This Position

5. INTERESTS & HOBBIES

6. INVOLVEMENT IN ADMINISTRATION, SERVICE, STUDENT LIFE & SUPPORT (INCLUDING STUDENT MENTORING) (Exclude: teaching and research)

Position Held
(where applicable)

Period of Service (mm/yy – mm/yy)

Highlight of Activities / Contributions

Examples:

Resident Fellow

Program Director

Vice-Dean (Student Life)

Staff Advisor

Project Lead

Jan 05 – Dec 08

Feb 13 – Jan 14

Jan 14 – Jul 17

Aug 16 – Jan 18

Aug 17 – Dec 18

Advisor to Hall residents on Rag & Flag

Revise curriculum

Initiated peer student support program in faculty

Advisor to Save the Environment Student Group

Introduce mentorship program in department

7. HOSTELS WHICH YOU HAVE RESIDED AS A STUDENT, WHERE APPLICABLE

From

To

Name of Hostel

8. LANGUAGE PROFICIENCY

Written & Spoken

Proficiency
(indicate fluent/good/fair)

Spoken Only

Proficiency
(indicate fluent/good/fair)

9. REASON(S) FOR APPLICATION AND WHY WOULD YOU MAKE AN EFFECTIVE HOSTEL MASTER

(500 words max)

10. PREFERRED NUS HOSTEL (Please tick one)

I would like to be considered for the position of Master in:

[ ] Halls of Residence only

[ ] UTown residence/PGP residence only

[ ] I have no preference

11. DECLARATION

I declare that the particulars in this application are true to the best of my knowledge and belief, and I have not willfully suppressed any material facts. Any misrepresentation or omission of information will be grounds for withdrawal of the appointment offer or for termination of the appointment.

I am aware that the information I have provided will be used solely for the purpose of assessing my application for the Master position.

__________________ _______________

Signature of Applicant Date