Online Application Form

Course Title:
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Class: Please make a selection.
* Course Start Date Please make a selection.

Upon successful submission of the course application, please note that you will be subject to a non-refundable course
registration fee indicated under NUS Extension's terms & conditions.

Please note that Registrant with multiple intake registrations received for a course shall be assigned to one of the registered
intakes at the sole discretion of NUS Extension. Please refer to NUS Extension's terms & conditions for the details.


General Student information

* Given Name (in BLOCK letters) (Mr/Mrs/Ms) :

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* Surname / Family Name

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* NRIC No.:

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* Email Address (For Company Sponsored applicants, please
indicate the email address of the company contact person):

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Local Mailing Address:
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* Contact Number (Mobile):

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Contact Number (Fax Number):

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Company Sponsorship:
NUS Status / Other Membership:
Student / Staff / Alumni / SIATP Number: A value is required.

 

Help Us Know

How did you know about us?
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Other Reason:
Religion:
Marital status
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Singapore address
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Street Name Exceeded maximum number of characters.
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Unit No Exceeded maximum number of characters.
Building Name Exceeded maximum number of characters.
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Permanent address (in home country)
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Unit No Exceeded maximum number of characters.
Building Name Exceeded maximum number of characters.
Postal Code Exceeded maximum number of characters.
Country
Highest qualification Exceeded maximum number of characters.
Type of valid pass held during stay in Singapore
(e.g. EP, DP, Social Visit Pass, student pass etc),
Contacts in case of emergency: Exceeded maximum number of characters.

 

If Company Sponsored

* Bill to:

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* Company Billing Address: Exceeded maximum number of characters.

Present Position:

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* Contact Person's Name Exceeded maximum number of characters.

* Contact Person's Number :

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* Contact Person's Email Address:

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Sub-bu code :

* The fields are mandatory if company sponsored.

 

You will receive periodic communications to keep you informed of NEX’s products, services, events & training opportunities.
Please tick here if you do not wish to receive them.

* Yes, I have read, understood & accepted the terms & conditions
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* Mandatory field
  1. NUS Extension reserves the right to cancel or postpone the course at short notice.