AGENT Name : (as in NRI/Passport)

    Personal Detail

    *Document Required to be upload :
    1.Identification Card (IC)
    2.Photo passport size
    3.SPM/DIPLOMA/STPM/etc
    4.Registration Receipt

    1. Name : (as in NRI/Passport)

    2. NRIC (Malaysian Identity Card No.)

    3. Date of birthday

    4. Nationality

    5. Gender

    6. Marital Status

    7. Race

    8. Religion

    9. Postal Address

    10. Permanent Address

    11. Phone

    12. Email*

    Personal of parent / guardian

    1. Name

    2. Relationship

    3. NRIC (Malaysian Identity Card No.)

    4. Passport No

    5. Occupation

    please state:

    6. Salary range

    7. Postal Address

    8. Phone Number

    9. Employer’s Name

    10. Employer’s Address

    Contact Person in case Emergency

    1. Name

    2. Relationship

    3. NRIC (Malaysian Identity Card No.)

    4. Passport No

    5. Postal Address

    6. Phone Number

    Sponsor Particular

    1. Are you financially sponsored by an organization / agency?

    If YES Name the sponsorored body and sponsorship amount.

    If NO

    Programme Application

    Chose Programme you wish to register

    Please UPLOAD Required document

    Identification card – Malaysian front & Back *

    Passport photo size *

    SPM Result *

    DIPLOMA / STPM / FOUNDATION / etc *

    Registration Fees Receipt – RM 100 *

    Declaration As to Fitness

    Please state if any disablility that reqired special attention

    Declaration By Applicant