AGENT Name : (as in NRI/Passport)
*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 MaleFemale
6. Marital Status SingleMarried
7. Race
8. Religion
9. Postal Address
10. Permanent Address
11. Phone
12. Email*
1. Name
2. Relationship FatherMotherSister / brotherOther
3. NRIC (Malaysian Identity Card No.)
4. Passport No
5. Occupation Government – position held :Private – position held :Self employed :Other – please state :
please state:
6. Salary range Less than RM1,000 a monthBetween RM1,000 – RM2,500 a monthBetween RM2,500 – RM5,000 a monthMore than RM5,000 a month
7. Postal Address
8. Phone Number
9. Employer’s Name
10. Employer’s Address
5. Postal Address
6. Phone Number
1. Are you financially sponsored by an organization / agency? YesNo
If YES Name the sponsorored body and sponsorship amount.
If NO Apply PTPTN LoanSelf Sponsored
Chose Programme you wish to register Foundation in managementDiploma in business administrationDiploma in Logistic ManagementDiploma in AccountingDiploma in Earlychildhood EducationBachelor In business administrationBachelor education Earlychildhood education
Identification card – Malaysian front & Back *
Passport photo size *
SPM Result *
DIPLOMA / STPM / FOUNDATION / etc *
Registration Fees Receipt – RM 100 *
Please state if any disablility that reqired special attention
Declaration By Applicant By thick this button I attest that i have personally filled in this form and the information contained herein is complete and accurate ti the best of my knowledge.I understand that with holding information or giving false information will make me ineligible for admission.I also undestand that i may be required to appear fo an interview or to undergo such tests as requested by the University as a condition for admission to the programme of study for which i have applied.