Online Registration Form

BAHAGIAN 1 (SECTION 1) : PILIHAN PROGRAM (PROGRAMME APPLIED)

Tarikh Kemasukan *
(Date of Intake)

Program Pilihan *
(Programme Applied)

BAHAGIAN 2 (SECTION 2) : MAKLUMAT PERIBADI (PERSONAL BIODATA)

Nama *
(Name)

No. Kad Pengenalan *
(NRIC / Pasport No.)

(example: 900425-14-5792)

Lain-Lain Pengenalan Diri
(Other ID No)

Jantina
(Gender)

Taraf Perkahwinan
(Marital Status)

Bangsa
(Race)

Alamat Surat Menyurat *
(Correspondance Address)

Poskod *
(Postcode/Zipcode)

Negeri *
(State)

Negara *
(Country)

Alamat Email*
(Email Address)

(example: johndoe@yahoo.com)
(Applicant required to fill in the correct e-mail address. The offer letter will be sent to your e-mail)

No. Telefon Rumah *
(House Phone No)

(example: 03-61898908)

No. Telefon Bimbit *
(Handphone No)

(example: 012-3456789)

Tarikh Lahir
(Date of Birth)

Month: Day: Year :

Agama
(Religion)

Warganegara
(Nationality)

BAHAGIAN 3 (SECTION 3) : MAKLUMAT AKADEMIK (ACADEMIC BACKGROUND)

Jenis Peperiksaan *
(Type of Examination)

Lain-lain(Others)

Tahun *
(Year)

Jumlah Mata Pelajaran *
(No. of Subject Taken)

Senarai Mata Pelajaran dan Gred *
(List of Subjects and Grades)

Sila isi mengikut keputusan peperiksaan yang sebenar
(Please fill up according to your exam result)

BAHAGIAN 4 (SECTION 4) : PENGAKUAN (DECLARATION)

Saya mengaku bahawa sepanjang pengetahuan saya, maklumat yang saya berikan adalah tepat dan benar. Saya juga
faham sekiranya terdapat sebarang bentuk pemalsuan maklumat, pihak Kolej berhak menolak permohonan ini, menarik
kembali tawaran atau menamatkan pengajian saya pada bila-bila masa.

I hereby declare that the information contained herein is complete and accurate to the best of my knowledge. I fully
understand that withholding or giving false information, the college has the right to reject or revoke my application
or terminate my studies at any time.