STUDENT APPLICATION FORM

Applicants must meet the entry requirements for the selected programme prior to the submission of this form. Please complete all sections in BLOCK LETTERS (BLUE/BLACK) ink only. Please ensure that all the required fields are completed and all supporting documents are attached and sent to the address given on the last page of the form.

SECTION A: COURSE
Course: School: Damansara Jaya Campus Date of admission: Mode of study: Application status: Part Time New Full Time Transferred from other institutions in Malaysia Section 13 Campus Penang Campus
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SECTION B: PERSONAL INFORMATION

First Name(s) as stated in IC/Passport: Surname/Family Name as stated in IC/Passport: IC/Passport No.: Date of Birth (dd/mm/yy): Gender:

Nationality: Marital Status:

Correspondence/Permanent Address (P.O. Box address is not acceptable for international applicants):

City:

State:

Country: Mobile Phone No.:

Post Code:

Home Telephone No. (Please include all international codes): Email:

Name of Parent/Guardian: Relationship: Parent/Guardian Address (if different from above): Occupation:

City:

State:

Country: Mobile Phone No.:

Post Code:

Home Telephone No. (Please include all international codes): Email:

For Malaysian applicants only Religion: For International applicants only Malaysian Immigration Pass held: Malaysian PR Work Permit Social Visit Student Dependent Diplomatic MM2H None Other (please specify): Race: Malay Chinese Indian Pribumi Other

Immigration Pass expiry date (dd/mm/yy):

For applicants from the Peoples Republic of China only Please advise as to which Malaysian Consulate you wish to obtain your single entry visa into Malaysia: Shanghai Beijing Guangzhou

SECTION C: ACADEMIC QUALIFICATIONS

If space given is not sufficient, please include an attachment. Academic Qualifications (Include last school attended and examinations taken) Start date End date Institution name and location Qualification obtained

English language proficiency Please tick if the medium of instruction for your highest qualification achieved was in English. (A letter issued by the university is required as proof for applicants whose first language is not English). If not, please complete the table below and enclose a copy of your English language qualification. English Qualification (e.g. IELTS, TOEFL, MUET) Year obtained Score

SECTION D: OTHERS
Will your course be self-financed or sponsored? If sponsored, please provide details of your sponsorship Self Organisation/government sponsor

Where did you learn about KDU UC Advertisement Other Agent Personal recommendation Internet University brochure

SECTION E: KDUS RULES & REGULATIONS

1. KDU policy over Subjects Registration. You are required to enrol for the subjects within 7 days from the date of commencement of the programme. Enrolment after the stipulated date is subjected to the approval from Head of Academic Department. 2. Attendances & Results. You are to maintain the following regulations mandated by Ministry of Education Malaysia (MOE): To maintain fulltime studies status of registering NOT less than 3 subjects per semester. To attend all lecturers, tutorials, practical and other classes as required by the programme. To maintain 80% of class attendances for each subject per semester, failing which, you will be barred from the final examination. To maintain at least GPA 2.0 (Grade C) and above for each subject in the semester. INTERNATIONAL STUDENTS RULES & REGULATIONS 1. Students via Application. Your acceptance to KDU is subject to the approval of your student visa application by EMGS & the Immigration Department Malaysia. KDU will not be held responsible for the time taken to process your application and/or rejection of your application by the relevant authorities. 2. Validity of Passport & Pass. You must hold a valid passport and student pass for the entire duration of your stay in Malaysia. You are responsible for the validity of any kind of immigration pass / and must abide by the rules and regulations imposed by KDU and the Immigration Department Malaysia. 3. Report to KDU. You are to report to International Office (IO), KDU within 3 days of your arrival, to pay all outstanding fees, to proceed for medical examination and submission of passport for endorsement of student pass.

4. Payment of Fee. You are required to report to the Admissions & Bursary Office to pay the programme fees and to present the original certificate(s) and supporting documents within 7 days after the commencement date of the programme (please refer to KDUs Bursary Policy). 5. Students with Diplomatic Passes are exempted from paying this bond. 6. Payment of Insurance, Medical Examination, Student Pass & Personal Bond. You shall bear all charges related to your insurance / medical examination / student pass / personal bond or penalty charged by EMGS & the Immigration Department Malaysia. 7. No Employment. You are not allowed to engage in any kind of work or occupation in Malaysia while holding a student pass unless you have obtained the approval from the Immigration Department. 8. Extension of Student Pass. You are required to pay RM 2,000 Advance Fee before applying to extend your student pass. All application for student pass must be submitted to the International Office 2 months before the expiry date of your student pass. 9. Withdrawal. You must inform KDU in writing if you wish to withdraw from the institution and report to the International Office for cancellation of your student pass. KDU reserves the right to forfeit the caution fee and inform the Immigration Department to cancel your student passes if you fail to do a proper cancellation before leaving the country. 10. Inactive. If you have registered but fail to attend any classes 1 month after the commencement date without informing KDU officially, you will be classified as withdrawn. All fees and security deposit will be forfeited and KDU will inform immigration to cancel your student pass. 11. Refund of Fees. Refund of fees is subjected to KDUs Bursary Policy. 12. Deferment. You must obtain the written approval from your Head of Department if you wish to defer your study (please refer to KDUs Bursary Policy). 13. Code of Conduct. You are required to abide by the KDU Code of Conduct and Code of Discipline and KDU Student Handbook. Students must abide and be bound by ALL applicable laws in Malaysia. This is regardless of whether the student has acquainted themselves to such regulations. KDU reserves the right at any time to elect new rules and regulations, to amend existing rules a regulations which shall take effect retrospectively and students are further advised to refer to the Students Handbook regularly for such amendments.

SECTION F: STUDENTS DECLARATION

I have read and I fully understand the terms and conditions and effects thereof listed in section E. I hereby expressly confirm my agreement thereto. I further undertake to perform all such obligations and / or comply with all terms and conditions set out in Section E on my part to be performed with, particularly but not limited to payment of all monies payable. I agree that any offer of placement is conditional on the accuracy of the information provided by me and upon my meeting the minimum pre-requisite results to enter into such programme. Signature of application: Date :

APPLICATION CHECKLIST Document checklist for Malaysian applicants 1 copy of IC 1 passport photo 1 certified true copy of ALL academic certificates & transcripts Additional documents for students transferred from other institutions in Malaysia (1 copy of MPW transcript, local students only) BM A Moral Education/Islamic Studies Malaysian Studies Not applicable Document checklist for International applicants 3 copies of passport (all pages, detail page(s) in colour, 2 years validity) 6 passport photos (blue background) 3 certified true copies of ALL academic certificates & transcripts Original NOC/Eligibility Letter Original Release Letter from previous Malaysian institution Payment of EMGS fee and registration fee Application form and all documentation should be sent to following address: Admissions and Bursary KDU University College Damansara Jaya Campus SS22/41, Damansara Jaya, 47400 Petaling Jaya, Selangor Darul Ehsan, Malaysia

THIS SECTION FOR OFFICE USE ONLY Admission Status Programme Code: Category of Acceptance: Full Entry Level: Conditional

Student I.D. No.: Date of Entry:

Academic requirements for Conditional Acceptance To submit a copy of certified actual result Other Conditions:

Remarks: Counselled by: Recruited by: Friend to friend Agent Introducers name: Company name & stamp: Introducers Student No.: Signature: Date:

Admission Process by: (Admission & Bursary Staff)

Signature:

Date: