INTERNATIONAL STUDENTS

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Please fill in the blank space on the application form below. Make sure you fill in all fields marked *
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 A. PERSONAL DETAIL
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Name :  *
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Passport No :  *
       
Gender :  Religion:  
       
Date of Birth :   Race:  
       
Age    Nationality:  
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Email :

 (example:name@yahoo.com)

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Address :  *
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City :  *
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Postcode :      *
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Student's Phone Number :
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Parent's Phone Number :
       
Relationship : Others:

 

 
Occupation :

 
Contact Number :

Residence:  Mobile:

 
Address  

 
     
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 B. COURSE APPLIED
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Program Option 1 : *
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Program Option 2 : *
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Program Option 3 : *
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 C. EMERGENCY CONTACT
 
Name :

 
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Contact Number : Residence:  Mobile:  
 
 D. ACADEMIC/ PROFESSIONAL QUALIFICATIONS
Highest Examination Passed:

'O' Level 'A' Level Diploma  Degree Others:

 
Exam Year
Name of Examination
School/Institution
Result
 
 E. WORK EXPERIENCE (IF ANY)
English Language Achievement

TOEFL IELTS MUET  Others:

 
Exam Year
Name of Examination
School/Institution
Result
 
 F. OTHERS INFORMATION
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  TV/Radio Friends Exhibition Newspaper
  Offer letter Website SMS  
  Others : *
         
 G. DECLARATION
 

I declare that the information provided by me in connection this application is true and correct. I undertake to inform City University College of Science And Technology immediately of any changes in address, phone numbers and other information provided by me in this application. I understand that City University College of Science And Technology reserves the right to vary decision regarding admission or enrolment made on this basis of incorrect or incomplete information. I hereby fully understood and agreed the all Fee Paid are NOT REFUNDABLE upon commencement and enrollment of the above course and to be bound by the Term and Conditions of the offer to study at City University College of Science And Technology.