ALUMNI ADVANCEMENT OFFICE INSTITUTIONAL ADVANCEMENT CENTRE

BORANG MAKLUMAT PERIBADI / PERSONALS DETAIL FORM

MAKLUMAT PERIBADI / PERSONAL INFORMATION
Nama yang didaftarkan semasa Ijazah Dasar / Pasca Ijazah Name registered as undergraduate / postgraduate Gelaran dan anugerah diterima (Cth: Tan Sri, Dato, Dr.) Please include title/honorifics No Kad Pengenalan Lama Old I/C No Alamat Tetap Permanent Address Alamat surat menyurat (jika berlainan dengan atas) Postal Address (if different from above) Alamat Email Email address Facebook (Jika ada) Facebook (if applicable) Nombor telefon (rumah) Telephone number (Home)

No Kad Pengenalan Baru New I/C No

Telefon bimbit Mobile number

MAKLUMAT PEKERJAAN /WORK INFORMATION

Nama Syarikat Company name Alamat Syarikat Company Address No Telefon Pejabat Office phone number No Fax Pejabat Office fax number Jawatan Post

optional

MAKLUMAT PENDIDIKAN / EDUCATION

*Kelayakan yang diterima dari UM Diploma Diploma Sarjana Muda Bachelor
Note Alumni Database verified via I/C number. Data in the database are private and confidential, to be accessed only by staff of the Institutional Advancement Centre (IAC), UM for official purposes.

Program yang diikuti

Program Enrolled

Year of Graduation

Tahun tamat pengajian

ALUMNI ADVANCEMENT OFFICE INSTITUTIONAL ADVANCEMENT CENTRE

BORANG MAKLUMAT PERIBADI / PERSONALS DETAIL FORM

Sarjana Master Doktor Falsafah PHD

Sila tandakan yang berkenaan / please tick which applicable

Note Alumni Database verified via I/C number. Data in the database are private and confidential, to be accessed only by staff of the Institutional Advancement Centre (IAC), UM for official purposes.