A. Name (as in I.C. / Passport) (PLEASE USE BLOCK LETTERS)
Title :	Mr Mrs Ms	Gender :	Male     Female
Surname :		Age :
Given Name :
Nationality :	Malaysian Others (please specify)
Race :	Malay Chinese Indian Pribumi (please specify): Others (please specify):
Date of Birth :	Day 1\n2\n3\n4\n5\n6\n7\n8\n9\n10\n11\n12\n13\n14\n15\n16\n17\n18\n19\n20\n21\n22\n23\n24\n25\n26\n27\n28\n29\n30\n31\n Month January February March April May June July August September October November December Year 1969\n1970\n1971\n1972\n1973\n1974\n1975\n1976\n1977\n1978\n1979\n1980\n1981\n1982\n1983\n1984\n1985\n1986\n1987\n1988\n1989\n1990\n1991\n1992\n1993\n1994\n1995\n1996\n1997\n1998\n1999\n2000\n2001\n2002\n2003\n2004\n2005\n2006\n2007\n2008\n	Place of Birth :
Residential Address :		Permanent Address :
Tel :		Mobile :
E-Mail :
B. Please indicate (√) the academic programme applied for
Foundation Studies
Foundation Studies
Foundation in Science & Technology
Certificate
Certificate in Business Studies		Certificate in Food & Beverage Service
Certificate in Hotel Operations		Certificate in Industrial Manufacturing & Maintenance
Diploma Programmes
Diploma in Accounting & Business		Diploma in Aesthetic Management
Diploma in Aircraft Maintenance		Diploma in Biotechnology
Diploma in Business Information Technology		Diploma in Computer Science
Diploma in Culinary Arts		Diploma in Electrical & Electronic Engineering
Diploma in Hotel Management		Diploma in Mechanical Engineering
Diploma in Mechanical Engineering (Automotive)		Diploma in Mechatronics Engineering
Diploma in Medical Lab Technology		Diploma in Nursing
Diploma in Tourism Management		Diploma in Tourist Guide Operations
Degree Programmes
American Degree Transfer Programmes Business Liberal Arts Science & Engineering 3+0 Oxford Brookes University Programmes B.A. (Hons) Accounting & Finance B.A. (Hons) Business & Hospitality      Management Studies B.A. (Hons) Business & Management B.A. (Hons) Business & Marketing Management B.A. (Hons) Computing UK Degree Transfer Programmes Business Computing New Zealand Degree Transfer Programmes Commerce & Administration Computer Science E-Commerce Finance Management Marketing
English Proficiency Programmes
Intensive English Progamme		IELTS Preparatory Programme Full Time Part Time
C. I.C. / Passport Details
For Malaysian Student Only
New I.C. No :	- -	Old I.C. No :
For International Student Only
Passport No :		Date of Issue:
Place of Issue:		Expiry Date:
D. Academic History
Please enclose two (2) CERTIFIED copies of all qualifications achieved.
Qualifications Name of School / College Year Completed SPM / 'O' Level STPM / 'A' Level / UEC Certificate Diploma Others
E. English Results
Qualifications Grade Year Completed English 1119 TOEFL / IELTS
F. Declaration
I declare that all information submitted on this application form is correct. I authorise the university college to obtain offical records from any educational institution that I have previously attended. I understand that the university college reserves the right to vary or reserve any decision regarding admission or enrolment made on the basis of incorrect or incomplete information.