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Online Student Registration

Applicant Type

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Program Name

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Student Full Name

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Your Secure Number

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Email Address

Passport / IC

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Intake

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A. Personal Details

Sex

Date of Birth (MM/DD/YY)

Country

******Marital Status

State

Race/ Ethnicity

Parmanent Address

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Tell.(House) Tel.(Mobile)+ like-60126442362******

PostCode

Mailing Address- (if different with permanent address)

Father's Name/Guardian's Name

Occupation

Mother's Name

Occupation

Parmanen Address of Guardian

Exam Result (Local Student only)

School/Institution		Exam
Result:
B.Malaysia		Principles of Accounts
English		Basic Economics
Mathematics		Biology
Science		Chemistry
History/Sejarah		Physics
Geography		Add.Mathematics
Pendidikan Islam		Rasawwur Islam
Pendidikan Moral		Bahasa China
Perdagangan		Bahasa Tamil
English for Science & Technology		Bahasa Arab Komunikasi
Pendidikan Al- Quran dan as-Sunnah		Bahasa Punjabi
Pendidikan Syariah Islamiah

* Please kindly filled in your result for Qualification Validation.
* After you have filled up the online application, please fax or Scan your result and your IC to 03-7806 3479.

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