Universiti Kuala Lumpur Online Application: Intake 2014

APPLICANT REFERENCE Name IC Number Highest Qualification Submission Date : : : :

MUHAMAD SHAHMI BIN MOHAMED SHUKRI 920427035547 DIPLOMA 23-OCT-13

ACADEMIC QUALIFICATION

:: SPM / SPMV / REPEAT PAPERS (include at least one science/technical subjects) Exam Year Type of School School Name : : :

2009 SEKOLAH MENENGAH KEBANGSAAN AGAMA SEKOLAH MENENGAH KEBANGSAAN AGAMA MELOR
Grade

Subjects 1. 2. 3. 4. 5. 6. 7. 8. 9.

BAHASA MELAYU BAHASA INGGERIS MATEMATIK SEJARAH BAHASA ARAB TINGGI MATEMATIK TAMBAHAN FIZIK KIMIA BIOLOGI

A+ A A+ B+ B+ B B AB A+

10. PENDIDIKAN AL-QURAN DAN AS-SUNNAH :: OTHER QUALIFICATION (e.g Certificate / Diploma / Foundation / Matriculation) Qualification Specialization College/Institute Programme : DIPLOMA : : :
KEJURUTERAAN MEKANIKAL UNIVERSITI TEKNOLOGI MARA (UITM) DIPLOMA IN MECHANICAL

Completion/Expected Completion Date : 11/2013 * For final semester applicants, please state the latest CGPA and answer "No" to the following question. Last CGPA / Latest CGPA Have you completed your studies? :: MUET MUET Result Exam Year Have you registered MUET? Registration No : Band : : YES : 2324942MD0304-3503 : 2.44 : NO

Universiti Kuala Lumpur Online Application: Intake 2014

PROGRAMME APPLIED 1. M11 2. M13 3. F18
- BACHELOR OF AIRCRAFT ENGINEERING TECHNOLOGY (HONS) MECHANICAL (JANUARY 2014) - BACHELOR OF AIRCRAFT ENGINEERING TECHNOLOGY (HONOURS) IN AVIONICS (JANUARY 2014) - BACHELOR OF ENGINEERING WITH HONOURS (MECHANICAL) (JANUARY 2014)

Do you agree if being offered into other programmes in UniKL? :

NO

PERSONAL INFORMATION Name NRIC Number : :

MUHAMAD SHAHMI BIN MOHAMED SHUKRI 920427035547 KM 17, JALAN PASIR PUTEH, PADANG KALA, 16400 KELANTAN MALE MALAY ISLAM 27-APR-92 0179422749
Email Medical Background :
heelys_enyce@yahoo.com

Mailing Address :

Postcode State Gender Race Religion Date of Birth Telephone No

: : : : : : :

City

KOTA BHARU MALAYSIAN MELAYU SINGLE

Citizenship Ethnic Marital Status

: : :

Disability

TIDAK CACAT NONE

Parents/Guardian Information

Chronic Disease :

:: Father/Guardian Name :

MOHAMED SHUKRI BIN DERAMAN KM 17, JALAN PASIR PUTEH, PADANG KALA, 16400 KELANTAN 0179606866 SALMIAH BINTI IBRAHIM KM 17, JALAN PASIR PUTEH, PADANG KALA, 16400 KELANTAN 0179671373 RM5,001 - RM6,000
(Information is required for MARA/PTPTN study loan evaluation purposes)

Mailing Address :

Postcode State Tel. No

: : :

City

KOTA BHARU

:: Mother/Guardian Name :

Mailing Address :

Postcode State Tel. No

: : :

City

KOTA BHARU

:: Parents/Guardian Monthly Income Combined Income :