| Title |
Mrs.
Ms.
Mr. * |
| First
Name (surname) |
* |
| Last
Name |
* |
| Profession |
* |
| Date
of Birth |
* |
| I/C
or Passport No. |
* |
| Address |
* |
| City |
* |
| State/Province |
* |
| Zip/Postal
Code |
* |
| Country |
* |
| Contact
No. |
Home
* |
| |
Mobile
|
| Course
Registering for |
* |
| |
English
Mandarin
Bahasa * |
| |
Full-time
Part-time *
Notice:
Full-time (Monday-Friday 10 a.m - 5 p.m)
Part-time (Monday-Friday 10 a.m - 2 p.m / 2 p.m
- 5 p.m) |
|
Course Fees (RM) |
(Excluded with registration fee RM 50.00) |
| Email
Address |
* |
| Preferred
Month Of Commencement |
* |
| Payment
Method |
By Cash |
| |
By Cheque |
| |
|
Cheque
No.
|
| |
By Master Card |
| |
|
Credit
Card No:
|
| |
|
Expiry
Date:
|
| Need
hostel facilities |
Yes
No |
I hereby confirm that all the information given
about is true and agree to abide by the rules and
regulations of the Institute.
Please include the following documents with your
application and mail to:
- 2
photocopies of NIRC
- 2
passport size photographs
- Photocopy
of SPM certificate or any other relevant certifications
|
|
|