Intel Malaysia Scholarship Form

Personal Details
Name

Email Address

Mailing Address

Home Phone
Mobile Phone

School Details
Current School
If other, specify

Registration Date (DD/MM/YY)

Expected Completion (MM/YY)

Current Year

Courses (Hold Ctrl to select multiple fields)

B.Eng (Electrical-Electronics)
B.Eng (Electrical)
B.Eng (Electronics)
B.Eng (Computer)
B.Eng (Mechatronics)
B.Eng (Telecomm)
B.Eng (Others - please specify)
Masters (please specify)

If other, specify

Academic Qualifications Details

Completed Year /
Current Semester and Year
SPM

Results/CGPA/Grade

School / Institution

English
Mathematics
Additional Mathematics
Physics
Chemistry
Biology
Science

Total A1 (all subjects)

Total A2 (all subjects)
June 2009
Revision 1.0

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Intel Malaysia Scholarship Form

Academic Qualifications Details
Completed Year /
Current Semester and Year

Results/CGPA/Grade

School / Institution

STPM
Matriculation
Diploma
Degree
Masters
PhD

Parent's / Guardian's Information

Name of Parent / Guardian

Relationship

Sibling's Information
Name of Sibling

June 2009
Revision 1.0

Relationship

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