Wednesday, November 13, 2019
  This application is open to Malaysian citizens only.
  Fields with asterisk ( * ) are mandatory.
Personal information

Full name *  
NRIC *  Insert (e.g. 960101105000) 
Age *  
Race *  
Gender *   
Marital Status   
Permanent Mailing Address
Home Phone No.   
Mobile Phone No. *  (e.g. 012-1234567) 
Email Address *   

family background

Please enter the details of family members. Parents/Guardians' information are compulsory. For NRIC kinldy use number (e.g. 960101105000)  *
NameNRICRelationshipContact no.OccupationEmployerSalary range 

Applicants should currently be in the first or second year of university to apply. Unable to proceed. Kindly fill in the information which are marked with asterisk (*).