PERSONAL DETAILS
SECTION A
Name
*
First Name
Last Name
I/C or Passport Number
*
Nationality
Gender
Male
Female
Date Of Birth
-
Day
-
Month
Year
Date
Religion
Islam
Buddha
Hindu
Christian
Other
Race
Malay
Chinese
Indian
Other
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Telephone Number
-
Area Code
Phone Number
Mobile Number
*
-
Area Code
Phone Number
Email
*
example@example.com
Do you have any health problems that require the college attention?
*
Yes
No
Do you need Accommodation (Hostel)?
*
Yes
No
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SPM RESULTS
SECTION B
Bahasa Malaysia
*
Please Select
A+
A
A-
B+
B
B-
C+
C
C-
D
E
G
Sejarah
*
Please Select
A+
A
A-
B+
B
B-
C+
C
C-
D
E
G
Bahasa Inggeris
Please Select
A+
A
A-
B+
B
B-
C+
C
C-
D
E
G
Matematik
Please Select
A+
A
A-
B+
B
B-
C+
C
C-
D
E
G
Sains
Please Select
A+
A
A-
B+
B
B-
C+
C
C-
D
E
G
Pendidikan Islam/Moral
Please Select
A+
A
A-
B+
B
B-
C+
C
C-
D
E
G
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PREFERRED PROGRAM
SECTION C
SHORT COURSES
Proficiency in Al-Quran Recitation
Arabic Language
Pengajian Syariah / Usuluddin
CERTIFICATE
Certificate in Early Childhood Education
Certificate in Business Management
Automotive Apprentice Certificate Program (AACP)
DIPLOMA
Diploma in Beauty Management
Diploma in Automotive Management
Diploma in Accountancy
Diploma in Education (TESL)
Diploma in Information Technology
Diploma in Early Childhood Education
Diploma in Human Resource Management
Diploma in Business Management
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FINANCIAL ASSISTANCE / SCHOLARSHIP / SPONSORSHIP
SECTION D
SSPN-i Account
If applicant doesn't have SSPN-i account, please do so at MAYBANK or PTPTN COUNTER
Financial Assistance
PTPTN
KWSP
Baitulmal
Yayasan Negeri
Other
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INTEREST
SECTION E
Please select according to your interest . (You may select more than one)
Entrepreneurship
Cultural & Spiritual
Outdoor Recreational Activities
Computer & IT
Sports & Motoring
Charity & Education Activities
Other
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ACADEMIC QUALIFICATION DETAILS
SECTION F
Certified copies of certificate should be attached together.
Date Started & Completed
Name of School/Institution/University
Name of Exam/Qualification
Exam Results/Level/CGPA
1
2
3
4
5
Please upload certified copies of certificate
Browse Files
Cancel
of
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CO-CURRICULUM ACTIVITIES DETAILS
SECTION G
Certified copies of certificate should be attached together.
Position
Organisation/Club/Society
School/Institution/State Level
Year
1
2
3
4
5
Please upload certified copies of certificate
Browse Files
Cancel
of
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WORKING EXPERIENCE
SECTION H
Working Experience
Position
Company Name & Adress
Start Date & End Date
Salary
1
2
3
4
5
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PARENTS / GUARDIAN DETAILS
SECTION I
Fathers / Guardian's Detail
Name
First Name
Last Name
I/C or Passport Number
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Mobile Number
-
Area Code
Phone Number
Office Phone Number
-
Area Code
Phone Number
Email
example@example.com
Occupation
Position
Company Name
Mothers Detail
Name
First Name
Last Name
I/C or Passport Number
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Mobile Number
-
Area Code
Phone Number
Office Phone Number
-
Area Code
Phone Number
Email
example@example.com
Occupation
Position
Company Name
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MONTHLY INCOME RATE OF PARENT / GUARDIAN
SECTION J
Type a question
Less than RM1,000 per month
RM1,001 - RM2,500 per month
RM2,501 - RM5,000 per month
More than RM5,001 per month
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EMERGENCY CONTACT NUMBER
SECTION K
Name
First Name
Last Name
Mobile Number
-
Area Code
Phone Number
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Relationship
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NUMBER OF SIBLINGS
SECTION L
Name
Age
Occupation
Place
1
2
3
4
5
Submit
Should be Empty: