PREMIA TNC (SG) - DP Application Form

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(SG) DP Application - Questionnaire Form

Application Information

Pass Declaration

Is the Applicant holding an existing Work Pass ? Employment Pass, S Pass, Work Permit or Related Passes?

Yes

Has the Applicant ever held any Employment Pass, S Pass, Related Pass, Work Permit or Student?s Pass?

Yes

Is the Applicant a Singapore Citizen or Singapore Permanent Resident? Dependant?s Fin

Work Permit No./ S Pass No.

Yes

Pass Duration

Duration of Pass Applied For

(in months)

Relationship with Employment / S Pass Applicant / Holder

Relationship

Applicant's Personal Particulars

Name

Alias

(enter only if it appears on travel document)

Sex

Marital Status

Date of Birth

Nationality

Country of Birth

Country of Origin

Race

Religion

Applicant's Travel Document Information

Travel Document Type

Travel Document No.

Date of Expiry

Applicant's Personal Contact Details and Residential Address

Email Address

Mobile Phone Number

Residential Address

Applicant's Education / Last Drawn Salary Details

Section A - Educational Qualifications

Highest Qualification Attained

If None of the Above, please specify

Country of School

Name of School

Section B - School Enrolment

Is the applicant planning to study or currently studying in an educational institution in Singapore?

(excluding pre-school, nursery and kindergarten)

Enrolment Status

Name of School in Singapore

If None of the Above, please specify

Level of Education

If None of the Above, please specify

Estimated Start Date

Estimated Completion Date

Section C - Last Drawn Salary Details

Gross Monthly Salary (in Singapore Dollars)

Declaration by Applicant

Has the Foreigner ever been refused entry into or deported from any country?

Yes

Has the Foreigner ever been convicted in a court of law in any country?

Yes

Has the Foreigner ever been prohibited from entering Singapore?

Yes

Has the Foreigner ever entered Singapore using a passport issued by a different country?

Yes

Has the Foreigner ever entered Singapore using different name?

Yes

Has the Foreigner ever been a Singapore Citizen or Singapore Permanent Resident?

Yes

Has the Foreigner ever been issued a work visa by another country(s)?

If Yes, please provide the most recent details below. (Example: copy of work pass issued by the country)

Yes

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PREMIA TNC (SG) – DP Application Form