1.

NAMA PEMOHON
:
(APPLICANT'S NAME)
2. NO. PASPORT
:
(PASSPORT NO.)
[Untuk Pemohon Luar Negara Sahaja (For Foreign Applicants Only) ]
[Diisi Oleh Penjamin Kewangan Sendiri (To Be Filled In By Financial Guarantor) ]
1. NAMA PENJAMIN :
(GUARANTOR'S NAME)
2. NO. KAD PENGENALAN (I/C) / :
NO. PASSPORT (PASSPORT NO.)
3. ALAMAT :
(ADDRESS)
4. NO. TELEFON PEJABAT :
(OFFICE TELEPHONE NO.)
5. NO. TELEFON RUMAH :
(HOUSE TELEPHONE NO.)
6. TELEFON BIMBIT :
(MOBILE)
7. PEKERJAAN :
(OCCUPATION)
8. PENDAPATAN SEBULAN :
(INCOME PER MONTH)
PENGAKUAN PENJAMIN (DECLARATION BY THE FINANCIAL GUARANTOR)
Saya mengaku akan menjelaskan segala bayaran pengajian pemohon di UKM sekiranya pemohon tidak mampu/gagal menjelaskannya
(I hereby declare that I will settle all the outstanding payments due to UKM for the applicant for his/her study at UKM in the event that he/she is unable to do so)
Tarikh (Date) Tandatangan (Signature)
Mengilham Harapan, Mencipta Masa Depan
Inspiring Futures, Nurturing Possibilities
BORANG PENJAMIN KEWANGAN
(1)
(FINANCIAL GUARANTOR FORM)
(1)
1. NAMA PEMOHON
:
(APPLICANT'S NAME)
2. NO. PASPORT
:
(PASSPORT NO.)
[Untuk Pemohon Luar Negara Sahaja (For Foreign Applicants Only) ]
[Diisi Oleh Penjamin Kewangan Sendiri (To Be Filled In By Financial Guarantor) ]
1. NAMA PENJAMIN :
(GUARANTOR'S NAME)
2. NO. KAD PENGENALAN (I/C) / :
NO. PASSPORT (PASSPORT NO.)
3. ALAMAT :
(ADDRESS)
4. NO. TELEFON PEJABAT :
(OFFICE TELEPHONE NO.)
5. NO. TELEFON RUMAH :
(HOUSE TELEPHONE NO.)
6. TELEFON BIMBIT :
(MOBILE)
7. PEKERJAAN :
(OCCUPATION)
8. PENDAPATAN SEBULAN :
(INCOME PER MONTH)
PENGAKUAN PENJAMIN (DECLARATION BY THE FINANCIAL GUARANTOR)
Saya mengaku akan menjelaskan segala bayaran pengajian pemohon di UKM sekiranya pemohon tidak mampu/gagal menjelaskannya
(I hereby declare that I will settle all the outstanding payments due to UKM for the applicant for his/her study at UKM in the event that he/she is unable to do so)
Tarikh (Date) Tandatangan (Signature)
Mengilham Harapan, Mencipta Masa Depan
Inspiring Futures, Nurturing Possibilities
BORANG PENJAMIN KEWANGAN
(2)
(FINANCIAL GUARANTOR FORM)
(2)