STEP 1

Those marked with red * are required fields
*Please be reminded that any incomplete and incorrect information , your registration will not be processed.
► Enrollment details
Enrollment September 2018
Study Mode* Day
Evening
Course*

► Personal Information
IC no / Passport No *
Name*
Date of Birth*
Gender* Male
Female
Nationality*
Race* Religion*
Marital Status*
District*
Home Address*
Home Phone Number* Mobile Phone Number*
Permanent Address (If different from current Address)
Home Phone Number (Permanent Address)
Email* * required for sending registration form to your email
► Guardian Information
IC/Passport No.*
Name*
Nationality* Race*
Home No Mobile No
Home Address
Relationship*

► Medical Information
Medical History: