Form 16 - Psb Academy

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FORM 16
IMMIGRATION ACT
(CHAPTER 133)
IMMIGRATION REGULATIONS
Affix a recent
APPLICATION FOR A STUDENT’S PASS
Passport-size
[Regulation 14(2)]
photograph here
Notes: *Tick (√) where appropriate.
**Delete where appropriate.
New Application
Renewal Application (To continue the same course in the same school)
Transfer of School or Course
PART A – PARTICULARS OF APPLICANT
Foreign Identification No. (FIN)
(if applicable)
Full Name in BLOCK LETTERS (Underline Surname)
Name in Chinese Character, if
applicable
Alias, if any
Sex*
Date of Birth (DD/MM/YYYY)
□ Male
□ Female
Race
Religion (Denomination)
Nationality
Province / State & Country of Birth
Expiry Date of
Occupation, if any
Marital Status*
Employment/
Dependant’s Pass, if any
□ Single
□ Married
□ Divorced
□ Widowed
(DD/MM/YYYY)
Type and Serial no. of Travel Document Held
Expiry Date of Travel Document (DD/MM/YYYY)
School/Institute Applied For
Type of Course
Period Applied For:
From ____________________
To
____________________
Parents’ Residential Status (Applicable if parents are in Singapore)*
Father: □ Singapore Citizen
□ Singapore PR
□ Others
NRIC/FIN No:
Mother: □ Singapore Citizen
□ Singapore PR
□ Others
NRIC/FIN No:
Residential Address in Singapore
Tel. No.
List countries in which applicant has resided for one year or more during the last five years:
Period of Stay
Country
Address
From
To
Antecedent*
Have you ever been refused entry into or deported from any country?
Yes
No
Have you ever been convicted in a court of law in any country?
Yes
No
Have you ever been prohibited from entering Singapore?
Yes
No
Have you ever entered Singapore using a different Passport or Name?
Yes
No
If any of the answer is “YES”, please furnish details on a separate sheet of paper.
IMM 16
– 1 –
THIS FORM IS ISSUED FREE

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