Head, Group Communications (Malaysia) & Corporate Sustainability Department HSBC Bank Malaysia Berhad No.

2 Leboh Ampang, 50100 Kuala Lumpur

Date:________________

Dear Sir/Madam

Re: Application for HSBC Scholarship Awards 2009 (Undergraduate Programme) I, _____________________________________ (name of applicant) would like to apply for the HSBC Scholarship 2009. Please find attached the following documents: 1. Scholarship Application Form 2. Photocopy of NRIC 3. Academic results (Certified true copies) i) ii) iii) iv) v) SPM (or other equivalent) STPM (or other equivalent) MUET (or other equivalent) Latest academic results (if not a 1st year student) Other academic qualifications

4. Copy of letter of offer from university / college (Certified true copies) 5. Fee payment structure from university / college (Certified true copies) 6. EA Form (Parent/s) (Certified true copies) * Incomplete application will be automatically disqualified

Thank you

Yours sincerely,

____________________________ Signature Name:_________________________________ NRIC No:______________________________ Page 1 of 7

HSBC Bank Malaysia Berhad
(Company number 127776-V)

Please affix a recent photograph of applicant (non returnable)

HSBC Scholarship Awards 2009 Application Form (Undergraduate Programme)

Instructions:
Please attach all certified true copies of examination certificates and testimonials. Only short listed candidates will be notified via email. Incomplete applications will be automatically disqualified. Please return the completed form to:

HSBC SCHOLARSHIP APPLICATION - UNDERGRADUATE Group Communications (Malaysia) & Corporate Sustainability Department HSBC Bank Malaysia Berhad 8th Floor, Bangunan HSBC No. 2, Lebuh Ampang 50100 Kuala Lumpur Closing date: 10 July 2009 Section A Full Name: NRIC No.: Date of Birth: Correspondence Address: Gender: Age: Personal Details (To be completed by applicant)

Home Address (if different from correspondence address):

Tel No. (House/ Mobile): Section B Family Details

E-mail Address:

Father (or guardian)

Name: Relationship: Nationality: Occupation: Employer: Monthly Gross Income:

Mother (or guardian)

Name: Relationship: Nationality: Occupation: Employer: Monthly Gross Income:

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HSBC Bank Malaysia Berhad
(Company number 127776-V)

Name of Siblings (Brothers & Sisters)

Age

Relationship

Marital Status (Married / Single)

Occupation (if in school or employment, name and address of school or employer)

Monthly Gross Income

Section C

Field of Study

Course of Study: University / College / Institute: Type of University / College / Institute: Intake Date: (MMM/YY) Tuition Fee: (for the whole programme) - Please indicate fee to be paid by student

Public University (

Private University / College ( Expected date of Completion:

If you are not a first year student, please indicate your latest examination results Section D Secondary Education No of distinction (Grade 1A and 2A): ___________ No of distinction (Grade A): __________ (Grade B) : _____________ Results: __________________

SPM/ O Level or other equivalent STPM/ A Level or other equivalent MUET Level or other equivalent Section E Other Education

Other Qualifications: (Diploma / Matriculation / Foundation) Awarded by: (Institute / College / University) Results (CGPA):

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HSBC Bank Malaysia Berhad
(Company number 127776-V)

Section F

Other Financial Assistance ) No ( )

1. Are you presently receiving any financial assistance from any institutions/foundations/government? Yes ( Yes, please furnish details: 2. Do you have Perbadanan Tabung Pendidikan Tinggi Nasional (PTPTN) loan? Applied ( ) Approved ( ) ) No ( No ( ) )

3. Have you applied for any other Scholarships/Grants/Educational Loan? Yes ( Yes, please furnish details: No, why

Section G

Essay

1. About yourself / family background (maximum of 100 words)

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HSBC Bank Malaysia Berhad
(Company number 127776-V)

2. Why do you need a scholarship from HSBC? (maximum of 200 words)

3. What would you do if you were not offered this scholarship? (Maximum of 200 words)

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HSBC Bank Malaysia Berhad
(Company number 127776-V)

4. Explain about the course you have selected and why? (Maximum of 100 words)

Section H

Declaration By Applicant

I agree and accept that if I am successful in my application, i. HSBC Bank Malaysia Berhad (HSBC) will notify me in writing to formally offer me the scholarship; ii. I will be required to enter into a formal contract with HSBC and shall observe the terms and conditions set out therein. iii. HSBC will use all information including my personal data strictly for purposes relating to the Scholarship Awards, including the disclosure and transfer thereof to the selection committee and the media where necessary. iv. The information including any photo, visual and audio recording may also be used by HSBC or any of its Group Companies for publicising the Scholarship Awards. I hereby declare that the information given in this Application Form and in the documents (if any) attached hereto in support of my application is true and correct and that I have not suppressed any material fact. I agree and accept that if any information in this Application Form (including, without limitation, my particulars and the answers given in the questionnaire section) and in the attached documents (if any) is found to be false and/or inaccurate, my application shall be rejected; and where the scholarship has already been awarded to me, HSBC shall have the discretion to withdraw the same and I will reimburse HSBC all sums that have been released for my benefit under the Scholarship Award. I undertake to furnish the Bank with additional documents and/or information as and when required by HSBC. Name : I/C No.:

Signature : Date: ...

Referee: Name: Relationship:.. Known for: . Months/years Address:.. Contact Number: Profession: ..

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HSBC Bank Malaysia Berhad
(Company number 127776-V)

SURVEY FORM HSBC Scholarship Awards 2009

We would appreciate receiving your comments on this programme. This will help us review and improve our programmes in the future.

1. How did you hear about the HSBC Scholarship Awards?

HSBC Website (www.hsbc.com.my) Other website (please specify which website) Newspaper (please specify which newspaper)

: ( Y / N ) : __________________________________________ : __________________________________________

University / College / Teachers (please specify which institution) : ______________________________ Existing / Past HSBC Scholarship Recipient : __________________________________________ Others (please specify) : __________________________________________

2. Which of these criteria of the HSBC Scholarship programme appeals to you?

(please rate accordingly, 5 being the most appealing)

Scholarship Amount

5 5 5 5

4 4 4 4

3 3 3 3

2 2 2 2

1 1 1 1

No restriction on field of studies : No bonding required Education loan is permissible Others (please specify) : :

: ___________________________________________________

Name : ___________________________________ NRIC No : __________________________________

Thank you for your co-operation.

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HSBC Bank Malaysia Berhad
(Company number 127776-V)