Indication of Interest Form (FORM NO. – M54) Attach Photo Here

(FORM NO. – M54)
Indication of Interest Form
IMPORTANT INSTRUCTIONS:
 Use CAPITAL LETTERS only, throughout the application form.
 Kindly note that this form is used for an indication of interest for course enrolment at
MAGES and is NOT the official application form for admission or intake confirmation.
 MAGES reserves the rights to review and use data provided to follow up on candidate’s enquiry.
CONFIDENTIALITY:
 MAGES is committed to maintain the confidentiality of the applicant’s personal information
and undertakes not to divulge such information to any third party without the prior written
consent of the candidate.
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Attach Photo
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(Where Applicable)
Section A
Particulars of Applicant
Applicant’s Name (as in NRIC / Passport):
Chinese Character (if applicable):
Gender:
 Male Female
Date of Birth (dd / mm / yyyy):
Marital Status (cancel accordingly):
Single / Married / Divorced / Widowed
Nationality:
Country of Birth:
Residence Status in Singapore (if relevant):
NRIC / Fin No.:
Passport No.:
Email Address:
Email Address:
Passport Expiry:
Tel. No.(w/ International Code):
Mobile No. (w/ International Code):
Permanent Home Address:
Address for correspondence (if different):
Section B (For Official Use Only)
Course Interests Indication
Please Indicate Faculty:
Media Animation Games
 Entertainment
Intake Level Preparation
Highest Education Level:
PSLE
N’ Level
A’ Level
Diploma
Others:
O’ Level
Degree
Ver4.0 Dated 04/01/2016
Mode of Study:
Full-time
 Part-time
History:
Student
 Employed
Please Indicate Applicable Course Level:
Certification
Diploma
Advance Diploma
Degree
Others:
Private & Confidential
Preferred Intake (mm / yyyy):
Remarks:
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(FORM NO. – M54)
Indication of Interest Form
How Did You Come To Know About MAGES
 Newspaper / Magazine
Brochure / Flyer / Mailer
Exhibition / Road show / Seminar
 Website
 Email
Our Student (stated name & hp. no.):
TV / Radio
 ASIS Singapore Chapter
 Agent (stated name):______________________________
 Others (please
specify):_______________________________________________________________________________________
Candidate Acknowledgement
I hereby indicate my interest for the course as indicated in this form and declare that all information given is true and correct. I am
aware that this form is not the official application form for admission or intake confirmation. I agree that MAGES is authorized to
use the above information for the purpose of verification and intake consideration. I also agreed to abide by the decision of MAGES
as to my eligibility for the course mentioned. I understand that completing this form does not guarantee me a placement in MAGES.
I agree that I will have to officially register for my course of study with MAGES Institute of Excellence should there be a suitable
intake for my interest.
Candidate’s Name & Signature:
Date:
All rights reserved MAGES Institute of Excellence Pte. Ltd.
Ver4.0 Dated 04/01/2016
Private & Confidential
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