Taman Ilmu Ikram (Ikram Park) Form: KLIUC – F51

Jalan Serdang-Kajang Issue No: 1

43000 Kajang Rev. No: 6
Selangor Darul Ehsan Page No: 1 of 1
Malaysia
Tel: No: 603-8926 6993/ 87383388
Fax: 603-8925 9846 / 8734 1021
e-mail: inquiry@kliuc.edu.my
http: / / www.kliuc.edu.my
INTAKE: mm/yy
APPLICATION FOR ADMISSION
CODE:
INTERNATIONAL STUDENTS
PLEASE COMPLETE IN BLOCK LETTERS AND TICK (√ ) WHERE APPLICABLE.

PROGRAMME APPLIED
1st Choice:

2nd Choice :

3rd Choice :

NAME: SURNAME: AGE:

HOME ADDRESS/STREET: POSTCODE:

(COUNTRY)
TOWN : STATE: COUNTRY:

E-MAIL: CONTACT NO:

DATE OF BIRTH: dd / mm / yy BIRTH PLACE: SEX: MALE FEMALE

HIGHEST ACADEMIC QUALIFICATION: STATUS : MARRIED SINGLE

PASSPORT NO: DATE OF ISSUE: PLACE OF ISSUED:

EXPIRY DATE: COUNTRY:

NATIONALITY: RELIGION:

NAME OF FATHER/ GUARDIAN: OCCUPATION:

HOME ADDRESS:

POSTCODE:

EMERGENCY CONTACT NO: MOBILE:

CONTACT PERSON : RELATIONSHIP:

DECLARATION:

I agree to abide by the policies and regulations of KLIUC. I FOR OFFICE USE ONLY
understand that any information given falsely will affect the CHECKLIST OF DOCUMENT

decision on my application, and may result in my eligibility for

admission / enrollment. F 1 photocopy of passport (whole booklet with all pages)
F 6 passport-sized photographs （Blue Background）
Signature of Applicant :
Date: F 2 certified true copies of all academic qualifications (in English
translation) / transcripts
F 2 certified true copies of English Language proficiency papers
F Health Examination Report
F Processing Fees RM 450

INTRODUCER:
Name :

NRIC / PASSPORT No : Staff/Student ID :

Company Name :

HP No :
 INTAKE March June November

A. ENGINEERING PROGRAMMES
F DCE - Diploma in Civil Engineering
F DEE - Diploma in Electrical and Electronics Engineering
F DEC - Diploma in Electronics & Communication Engineering
F DAE - Diploma in Automotive Engineering
F DME - Diploma in Mechanical Engineering
F BCE - Bachelor of Civil Engineering (Hons)
F BEE - Bachelor of Electronics Engineering (Hons)
F BTCM - Bachelor of Technology (Hons) in Construction Management
F BTAA - Bachelor of Technology (Hons) in Applied Automotive
F BTCW - Bachelor of Technology (Hons) in Water and Wastewater
F BTBM - Bachelor of Technology (Hons) in Building And Infrastructure Maintenance
F MCE - Master in Civil Engineering (by research)

B. BUSINESS AND ACCOUNTING PROGRAMMES

F DBA - Diploma in Business Administration
F DMA - Diploma in Marketing
F DAC - Diploma in Accounting
F BBAE - Bachelor of Business Administration (Hons) in E-Commerce
F BBA - Bachelor of Business Administration (Hons)
F BAC - Bachelor of Accountancy (Hons)
F MBA - Master in Business Administration

C. INFORMATION TECHNOLOGY PROGRAMMES

F DIT - Diploma in Information Technology F BITNT - Bachelor of IT (Hons) in Network Technology
F DSC - Diploma in Software Engineering F BITSE - Bachelor of IT (Hons) in Software Engineering
F DNMT - Diploma in Network and Mobile Technology F BCS - Bachelor of Computer Science (Hons)

D. COMMUNICATION AND LANGUAGE STUDIES PROGRAMMES

F DCC - Diploma in Corporate Communication
F DEPC - Diploma in English for Professional Communication
F BCC - Bachelor of Communication (Hons) in Corporate Communication
F BEPC - BA (Hons) English for Professional Communication
F BCA - Bachelor of Communication (Hons) in Advertising

E. ARCHITECTURE & BUILT ENVIRONMENT PROGRAMMES

F BAR - Bachelor of Architecture
F BSAR - Bachelor of Science (Architectural Studies)
F DAR - Diploma in Architecture
F DGE - Diploma in Geomatic Engineering

F. APPLIED SCIENCE & FOUNDATION PROGRAMMES

F BDS - Bachelor of Decision Science (Hons) F FCE - Foundation in Engineering
F BMT - Bachelor of Materials Technology (Hons) F FCB - Foundation in Business
F DMT - Diploma in Materials Technology

G. OTHER PROGRAMMES

F IEP - Intensive English Programme (Full-time) F IJP - Intensive Japanese Programme (Part-time)
F IMP - Intensive Mandarin Programme (Part-time) F PS - Public Speaking (Part-time)
F EW - English for The Workplace (Part-time) F IELTS - Preparation for IELTS (Part-time)
F EAP - English for Academic Purposes (Part-time) F MUET - Preparation for MUET (Part-time)
F IAP - Intensive Arabic Programme (Part-time)

7-Jul-09 V5.09