eForm 16
IMMIGRATION ACT
(CHAPTER 133)
IMMIGRATION REGULATIONS
APPLICATION FOR A STUDENT'S PASS
[REGULATION 14(2)]
All fields with * are mandatory.
PART A - PARTICULARS OF APPLICANT
Foreign Identification No.(FIN) Malaysian ID No.
(if applicable)
*Full Name in BLOCK LETTERS (Underline Surname) Alias, if any *Birth Certificate No.
KULDEEP SINGH
25756/15
*Race *Religion (Denomination) *Sex *Date of Birth (DD/MM/YYYY)
SIKH PUNJABI MALE 12/10/1993
Email Address *Nationality *Province/State *Country of birth
Chandpal2016@[Link] INDIAN PUNJAB INDIA
Expiry Date of *Occupation *Marital Status
Employment/Dependant's
Pass if any (DD/MM/YYYY)
STUDENT UNMARRIED
*Type of Travel Document Held *Serial No. of Travel Document Held *Issue Date of Travel Document
(DD/MM/YYYY)
PASSPORT N0266881 05/06/2015
*Country of Issue of Travel Document Place of Issue of Travel Document *Expiry Date of Travel Document
(DD/MM/YYYY)
INDIA AMRITSAR
04/06/2025
*School/Institute Applied For *Course *Period Applied For
KINGSTON INTERNATIONAL DIPLOMA IN BUSINESS & SALES
SCHOOL MANAGEMENT From To
*Parents' Residential Status
Father: NONE OF THE ABOVE NRIC/FIN No: NA
Mother: NONE OF THE ABOVE NRIC/FIN No: NA
Residential Address in Singapore Tel. No.
Have you resided in any country for one year or more during the last 5 years?*YES/NO
List countries in which applicant has resided for one year or more during the last five years:
Country Address Period of Stay (MM/YYYY)
From To
NO
*Antecedent
*Have you ever been refused entry into or deported from any country, including Singapore? YES/NO
*Have you ever been convicted in a court of law in any country, including Singapore? 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
ANTECEDENT'S REMARKS
IMM16
-1-
PART B - DECLARATION BY APPLICANT
I hereby declare that all the particulars furnished by me in this application are true and correct.
I undertake not to study without a Student's Pass.
I undertake not to misuse controlled drugs or to take part in any political or other activities during my stay in Singapore which would make me an undesirable or
prohibited immigrant under the Immigration Act.
I undertake to comply with the provisions of the Immigration Act and any regulations made there under or any statutory modification or re-enactment thereof for
the time being in force in Singapore.
I undertake not to be involved in any criminal offences in Singapore.
I undertake not to indulge in any activities which are inconsistent with the purpose for which the immigration passes have been issued.
I further undertake not to be engaged in any form of employment or in any business, profession or occupation in Singapore whether paid or unpaid, without a
valid work pass issued under the Employment of Foreign Manpower Act (Cap. 91A). I understand that industrial attachment and/or on-the-job training (whether
provided by my school or otherwise) is also considered as employment under the Employment of Foreign Manpower Act and requires a valid work pass.
I am aware that overstaying or working illegally in Singapore is a serious offence and on conviction, the penalties may include mandatory imprisonment and
caning.
I understand that if the Controller of Immigration is satisfied that I or any member of my family breaches this undertaking or becomes an undesirable or
prohibited immigrant, he will cancel my immigration pass and the passes of the members of my family, and we may be required to leave Singapore within 24
hours of such cancellation.
I give my consent for your department to obtain and verify information from or with any source, as you deem appropriate for the assessment of my application
for immigration facilities.
Remarks/Explanation (if any):
*I have read and agreed to the declaration.
11/04/2022
................................... ............................................................................................
Date Signature of Applicant
IMM16
-2-
ADDITIONAL INFORMATION ON APPLICANT FOR APPLICATION FOR STUDENT'S PASS
[eFORM V36]
PART A - APPLICANT'S PARENTS AND/OR STEP PARENTS
Full Name Relationship Date of Birth Nationality Residential Occupation
(As appears in travel document) (DD/MM/YYYY) Status in
Singapore
SUKHWINDER KAUR MOTHER 01/01/1955 INDIAN N/A HOUSEWIFE
SURJIT SINGH FATHER 01/02/1955 INDIAN N/A FARMER
PART B - APPLICANT'S SPOUSE
Full Name Relationship Date of Birth Nationality Residential Occupation
(As appears in travel document) (DD/MM/YYYY) Status in
Singapore
PART C - APPLICANT'S NATURAL SIBLINGS
Full Name Relationship Date of Birth Nationality Residential Status in Singapore
(As appears in travel document) (DD/MM/YYYY)
PART D - APPLICANT'S EDUCATIONAL BACKGROUND (INCLUDE COURSES ATTENDED IN SINGAPORE)
Name of Country State or Language of Period of Study Qualification Educational
Schools/Colleges/Universities Province Instruction (Academic/Professional) Certificate No.
(In Chronological Order) Obtained
From To
SHAHEED SWAR INDIA PUNJAB PUNJABI 2009 2010 MATRICULATION 071871
SARAJ SINGH GOVT.
HIGH SCHOOL
GOVT. SENIOR INDIA PUNJAB PUNJABI 2011 2012 SECONDARY 078788
SECONDARY
SCHOOL MAKHU
Obtained a pass in English : Yes / No YES
I do not have any information to declare for the above Part D.
PART E - APPLICANT'S EMPLOYMENT HISTORY/OTHER ACTIVITIES (INCLUDE PRACTICAL TRAINING,
INDUSTRIAL ATTACHMENT AND INTERNSHIP IN SINGAPORE)
Name of Companies Country Period of Working Position Held Nature of Duties
From To
I do not have any information to declare for the above Part E.
Remarks/Explanation (if any)
V36
-3-
PART F - APPLICANT'S FINANCIAL SUPPORT
Applicant Average Monthly Income for past 6 months: SGD Applicant's Average Monthly Income for past 6 months: SGD
Current Saving: SGD Spouse Current Saving: SGD
Applicant's Average Monthly Income for past 6 months: SGD Applicant's Average Monthly Income for past 6 months: SGD
Father Current Saving: SGD Mother Current Saving: SGD
Other financial support (eg. scholarship, study loan, funds from
relatives):
If yes, please furnish details (eg. amount in Singapore Dollars)
PART G - APPLICANT'S SINGAPORE CITIZEN/ PERMANENT RESIDENT PARENTS'/ STEP PARENTS'
ADDITIONAL INFORMATION
Additional Information for Applicant's Parents/Step Parents
Full Name Relationship Marital Status Marriage Marriage Date Divorce Divorce Date Custody of
(As appears in travel document) Certificate No. Certificate No. Applicant
Educational Details for Applicant's Parents/Step Parents
NO N.A.
Full Name Relationship Name of Country Highest Educational Educational
(As appears in travel document) School/College/University Qualification Certificate No.
(Academic/Professional)
Employment Details for Applicant's Parents/Step Parents N.A.
Full Name Relationship Name of Company Monthly Annual Income for Average monthly CPF
(As appears in travel document) Income (SGD) the Past 1 year contribution for the past 1
(SGD) year (SGD)
PART H - APPLICANT'S SINGAPORE CITIZEN/PERMANENT RESIDENT SPOUSE'S ADDITIONAL
INFORMATION
Marriage Certificate No.: Date of Marriage:
Spouse's Highest Educational Details N.A.
Name of School/College/University Country Highest Educational Qualification Educational Certificate No.
(Academic/Professional)
Spouse's Current Employment Details N.A.
Name of Company Monthly Income (SGD) Annual Income for the Past 1 year (SGD) Average monthly CPF
contribution for the past 1
year (SGD)
PART I - DECLARATION
I hereby declare that all the particulars and information given in this application for a Student's Pass is true and correct.
....11/04/2022.................... .........KULDEEP SINGH............................................... ............................
Date Name and Signature of Applicant
WARNING
IT IS AN OFFENCE UNDER THE IMMIGRATION ACT TO MAKE ANY FALSE STATEMENT, REPRESENTATION OR DECLARATION IN CONNECTION
WITH THIS APPLICATION