RECRUITED BY:

(To be filled up by Agent/Counselor)

Name
n.la

AgentNo.:m

INTERNATIONAL UNIVERSITY COLLEGE OF TECHNOLOGY TWINTECH

lw

AMD 001-7.2

-cL

MSC-Status

Company

APPLICATION FOR ADMISSION

Please read Section 6 before completing form and ensure that the form is completed correctly.

1) Please complete in BLOCK 2) Tick ( ) where applicable Course

LETTERS

lCertificate Ioiplora !Higl.'er

Semester

National

Diploma ID"gr""

Student No.
How do you know about us?

l--l

Rdvertisement

open

oay

wult

ln

l--l

Education Fair:

l-l lntroduce byfriends l--l teterurketing

Name
(as

l--l oth"rs

per l/C/Passport)

l/C/Passport No.
Place of Birth Race

Nationality
Religion Marital Status

Date of Birth
Sex

nSingle

EMarried

EMale nFemale

Age

Current
Address

Postcode

Telephone No.

Home/Mobile
CountrylAteaCode

E-mail

Permanent Home
Address

Postcode

Telephone No.
Countryl Area Code

E-mail

Parent

Guardian's Name Relationship

Occupation

fficeTel.No.
Countryl Area Code

Please list all School

/ College / Professional qualifications that you have taken from Age 15 and their results.

A. SPM / SPM(V) / O-Level

Bahasa

v""'l---l
Bahasa lnggeris

Ll I LI sejarah I Kejuruteraan nwam f

Sains

Fizik

Melayu I

Matematik
Biologi Perdagangan Agama lslam Lukisan Kejuruteraan

MatematikTambahan
Sains

Kimia
I

Tambahan

Prinsip Akaun Geografi Kejuruteraan Jentera

B.STPM/A-Level
Subject
1

v"u'f---l
Gred

Subject

Gred -l---_l

a 3

E
OthersCertificate/Diploma
Semester
Year
CGPA

4
5

G.

Semester 4
5

t
D. English Proficiency

CGPA

How would you rate your proficiency in the English Language? (Please tick in the appropriate box).

Excellent
Spoken

Good

Fair

Weak

Written
Reminder: Please attach a copy

ofthe results ifany.

Please refer

to Section 6

We confirm that, to the best of our knowledge, the information given in this form is correct and complete.We have read the instructions, in particular those relating to this section.We understand the content says and abide by the conditions set which we accept as conditions of this application.

Applicant's signature

Parent's / Guardian's Signature

Date

Date

Fees

1.1

Registration fees are not transferable, refundable and cannot be deferred.

Failure to settle outstanding fees within the prescribed period may result in exclusion from the University College's Register.

1.2

1.3 Any refund of fees or deposit, where applicable, will be at

Department.

the. discretion

of the University College's

Finance

1.4 Registration fee can be made before or on registration day by cash or cheque / bank draft.
payments through post.

Please do not send cash

2,
2.2

Withdrawal
Registrar in writing if they are withdrawing from a course of study.

2.1 Students must inform the

Please note that in the event of a student failing to complete a course of study, the University College is not obliged to return any part of the fees paid by or on behalf of the student.

3.
3.1

Accomodation
Upon registration to hostel, student is given a trial stay for 2 weeks and decides either to stay or to quit from the present hostel. lf he chooses to quit from hostel, he has to fill on Hostel Quit Form in 3 copies for verification and
approval.

3.2 After

the trial duration of stay ends, student MUST complete the 6 monts minimum stay requirement. study, he is allowed to vacate the house and must follow the quit procedures.

lf he quits

3.3

After completing the minimum requirement 6 month stay, student is given an option to extend or to quit from the hostel.The maximum stay allowed for every student is for one and half years or equivalent to 3 or 4 semester.

3.4 Management reserve the right to instruct the student to vacate the hostel for any reasonable cause. 3.5 Every student who stay in the hostel must abide

to rules & regulations

as

approved by IUCTT (refer attachments).

4.
4.1

Transfer between Courses A student may transfer from one Course to another within the University College only with the agreement of the appropriate authorities. No transfer will be allowed after 14 days from the commencement date of the new
semester.

5.
5.1

Rules and Regulations

All students must abide by the University College Rules and Regulations. Failure to do so may result in expulsion,
suspension, private or public sanctions.

5.2 Any criminal activities on the University College premises 5.3 The University College and its management

will be reported to the relevant authorities.

will not be held responsible for any damages,losses or injuries arising from the course of studentship with the University College.

5.4 The Disciplinary Board has the authority to suspend good name and security of its staff and students.

oil

anO expel any student behaving in a manner that affects

the

5.5 The University College reserves the right to revise the University College rules and regulations

without prior notice.

The University College reserves the right to accept or reject any application without assigning any reason.

Please attach the following when you submit your application

Check List

1 2 3 4 5 6 7

Completed Application Form.

Reply card with stamp RM0.30.

Certified copies of Academic Results relevant to entry requirements.

Proof of English Language Proficiencye.g.lELTS orTOEFL,if applicable.

Photocopy of ldentity Card or Passport (for lnternational Students). 4 photographs (passport size) with name written on the reverse. Portfolio consisting 3 pieces of Original Artwork if applicable.

E E E E E E E

For Office Use

W W W W W W W

FOR OFFICE USE ONLY

Application Accepted
Semester Admitted

f-l rutton"r I
1

conditionaloffer
3

l0

Conditions
Exemptions English Requirements
Remarks

Counselled by Name in Full

Date

Enrolled by Name in Full

Date

Data Entered

l-l

t"tt"r

of Offer lssued
Date

Please send

the completed form to:

INTERNATIONAT UNIVERSITY COLLEGE OF TECHNOLOGY MINTECH

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Tel Fox
Block
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Oprold by: Twintch Holdings Sdn.Bhd

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(260301

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Sli Domonsdlo Business Pork, Porsioron lnduslri, Bondol Sli Dqmqnsolo, 52200 Kuolo Lumpul, MAIAYSIA. i 03-6275 6277 0617,5275 5404 (Moin Compus), 03-6277 3167 / E9 (Wismo Twinlch)

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:03-62747055(ViceChoncellor),03-62742570(Admln),03-5274246.2(Acodomlc),
03-6277 (Ma1k6fing), 03-6274 2930 (Finonc), 03-6277 3190 (Wismo Twiniech)

Websiit : htlp://w.iucfi.edu.my