新 加 坡 中 医 学 院 ( 新加坡中医师公会主办 )
Singapore College of Traditional Chinese Medicine
640 Toa PayohLorong 4, Singapore 319522
Tel: 6250 3088 Fax: 63569901 Email: admin@singaporetcm.edu.sg
申请编号：Application no:   入学编号：Enrolment no:  
报读课程：（通过学院网站报名）
中医药基础证书(中文) CERTIFICATE IN BASIC THEORY OF TCM (CHINESE)
Form:REG-05
CONFIDENTIAL
照

片
个人资料 PERSONAL DETAILS
身份证号码NRIC/Fin No T0423231Z 国籍 Nationally：Singaporean 护照号码 Passport No：K4563722E
性别Gender 女Female 婚姻状况Marital Status： 出生日期 Date of Birth：2004-09-02
学历 QUALIFICATION
最高学历 Highest Qualification 大专Diploma
毕业院校名称
Name of Institution 		Ngee Ann Polytechnic 毕业年份Year Obtained ：2024
职业资料 EMPLOYMENT DETAILS
公司名称 Name of Company I Do For You Singapore 职位Occupation：Wedding Planner and Stylist
公司地址 Address of Company
联系方式CONTACT DETAILS
邮寄地址Mailing Address 469B Sengkang West Way #21-612 手机号码 Mobile：82687897
邮编 Post Code 792469 家庭电话号码 Home TEL No.：-
电子邮箱Email chuajiaxuan.np@gmail.com 公司电话号码 Office TEL No.：
其他 OTHERS
您如何了解到中医学院 How Did you find out about us： 学院网站 Our Website
您学中医的目的 Objective of study TCM： 掌握一技之长 To learn a skill
申请人申明 DECLARATION BY APPLICANT
1. 余谨声明，以上填报资料，均属事实 I hereby declare that all the particulars furnished by me in this application are true and correct.
2. 我明白中医学士学位课程不适用于中国籍（包括港、澳、台）申请者 I understand that Bachelor Degree Course in TCM is not applicable to the Chinese Nationality including Hong Kong, Taiwan and Macao.
3. 我明白资料提供不完整者，学院将无法进行入学评估 I understand that the college will not be able to enrol application who provided incomplete information.
4. 我明白报名表格信息仅用于课程管理的目的。 I understand that student’s information in the course application form should only be used for the purpose of course administration.
5. 我明白学院保留不录取申请者的权利 I understand that the College reserves the right to reject any application.
同意 I agree. 申请日期 Date 2025-05-25 13:02:19 网上提交报名表格无需签名
This is an online registration form, no signature is required.
办 公 室 填 写 FOR OFFICE USE ONLY
报名费 Application Fee 收据号码 Receipt No
经办职员 Staff-in-charge 经办日期 Date
注: Student’s particulars are strictly for the purpose of completing course submission information or
　　for other legitimate purposes.学生资料仅用于完成申请课程或其他合法用途。