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Foundation application form

Please make sure 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.
1. Programme details
2. Personal details
Arts
Title: Mr Miss Mrs Ms Other (please specify)
Forename/s (as per NRIC/passport)
Surname/family name (as per NRIC/passport)
Date of birth (day/month/year)
Gender
Nationality
Country of permanent residence
Correspondence address (please note this is the address to which the University will send all correspondence)
State Postcode Country
Town
Town
For Malaysian only Race Religion
Passport/NRIC No.
Business and Management Science Engineering
Proposed date of admission
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Telephone (daytime/work)
Permanent home address (if different from address above)
(Evening/home) Mobile
Email address Fax
State Postcode Country
Telephone (daytime/work) (Evening/home) Mobile
Email address Fax
Male Single Female Marital status Married
Reference No.
3. Academic qualifications
5. English language qualifications
4. Highest qualifications completed (examination for which result are known, including those failed)
Name of institution
Date of attendance (month/year)
Type of qualification
Date started Date awarded
All applicants should enclose the official transcript of their qualifications.
Education from Year 10/Form 5:
Have you obtained any other higher qualification than the above: Yes
Year started: Year completed:
Type of qualification:
Name of institution:

Subject/s
Subject/s
Result/grade/
mark/band
Result/grade/
mark/band
(Enclose a copy of your English language qualifications. Please specify which test you have taken with the results and the
date you took the test/or will be taking the test)
Type of test
Others
Date obtained Score
(please specify):
[M][M][Y][Y][Y][Y]
[M][M][Y][Y][Y][Y] [M][M][Y][Y][Y][Y]
[M][M][Y][Y][Y][Y]
[M][M][Y][Y][Y][Y] [M][M][Y][Y][Y][Y]
[M][M][Y][Y][Y][Y] [M][M][Y][Y][Y][Y]
[M][M][Y][Y][Y][Y] [M][M][Y][Y][Y][Y]
[M][M][Y][Y][Y][Y] [M][M][Y][Y][Y][Y]
[M][M][Y][Y][Y][Y] [M][M][Y][Y][Y][Y]
[M][M][Y][Y][Y][Y] [M][M][Y][Y][Y][Y]
[M][M][Y][Y][Y][Y] [M][M][Y][Y][Y][Y]
[M][M][Y][Y][Y][Y] [M][M][Y][Y][Y][Y]
[M][M][Y][Y][Y][Y] [M][M][Y][Y][Y][Y]
[M][M][Y][Y][Y][Y]
[M][M][Y][Y][Y][Y]
[M][M][Y][Y][Y][Y]
[M][M][Y][Y][Y][Y]
[M][M][Y][Y][Y][Y]
6. Personal statement supporting your application
Why have you chosen to study the programme you have applied for?
What made you choose The University of Nottingham Malaysia Campus?
7. Others
8. Declaration
Please check that your application is complete and that you have enclosed all the relevant documents
How will your course be financed? (Self or sponsored. If sponsored, please give relevant details)
Self Organisation/government sponsored
Do you have disability? Yes No
Do you have any criminal conviction? Yes No
If yes, please provide further details
If yes, please provide further details
Where did you learn about The University of Nottingham Malaysia Campus and its programmes? (Please tick one box only)
Advertisement (please state newspaper/journal)
Transcript of previous studies Copy of NRIC/passport English language qualification certificate
Application fee (for international applicants only)
Radio Exhibition/careers fair Personal recommendation University brochure
Careers office School Internet British Council
College/institution Agent
I certify that the information provided above is correct
Signature Date
When completed please return to:
Admissions Office
The University of Nottingham Malaysia Campus
Jalan Broga
43500 Semenyih
Selangor Darul Ehsan
Malaysia
t: +6(03) 8924 8000
f: +6(03) 8924 8002
w: www.nottingham.edu.my
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The University collects information about its students for various academic, administrative, health and safety reasons. The information is processed in accordance with the
Malaysian Personal Data Protection (PDP) Act 2010, and is disclosed to third parties only with the individual's consent or to meet statutory obligation. The information
provided on this application form will be stored electronically and used for administrative purposes by the University.