APPLICATION FOR ADMISSION

SECTION 1: PROGRAMME APPLIED

PROGRAMME Please affix a
recent passport
1) Diploma in Automotive Technology (KA 10060) size photo here.

INTAKE ____ Year _____ Month

SECTION 2: STUDENT PERSONAL DETAILS

Full Name* (as per I.C / Passport)

NRIC No*

Tel (House)* Tel (Off)

Mobile No.* Fax. No.

Email Address

Nationality Age*

Religion* Race*

Gender* ___ Male ___ Female Marital __ Single __ Married

Status*
Correspondence Address*

City / Town * Postcode*

State* Country*

Permanent Address* Same as above

City / Town * Postcode*

State* Country*

SECTION 3: PARENTS/GUARDIAN INFORMATION

Full Name* (as per I.C / Passport)

NRIC No*

Tel (House)* Tel (Office)

Mobile No.* Fax. No.

Email Address Relationship*

Occupation* Nationality*

Correspondence Address* Same as above

TEKAT Automotive College

No. 2, Jalan Hentian 5, Pusat Hentian Kajang, Jalan Reko, 43000 Kajang, Selangor, Malaysia.
Tel : 03-8733 8080 Fax : 03-8737 6886 E-mail : marketing@tekat.edu.my Website : www.tekat.edu.my
EMERGENCY CONTACT - In case of emergency, contact the following person:
Full Name* (as per I.C / Passport)

Tel (House)* Tel (Office)

Mobile No.* Fax. No.

Email Address Relationship*

SECTION 4: EDUCATIONAL BACKGROUND Attached Certificate

A) Vocational Qualification / SKM / Others

B) SPM (UEC, GCSE, A Level or equivalent)

C) Diploma / Degree / Post Graduate

D) Professional Certificate

Correspondence Address* Same as above

SECTION 5: EMPLOYMENT BACKGROUND (If Any)

Name Of Company Position Held (most Recent First) Period (Month/Years)

SECTION 6: GENERAL INFORMATION

1 Do you need accommodation arrangements?
Yes __ No __
2 Do you require financial assistance?
Yes __ No __

FOR OFFICE USE ONLY

Amount Received:_______________ Outstanding Balance:________________
Payment Mode: Bank draft Cheque Cash No:
____________

Received by: ___________________ Signature: ____________ Date:___________

Declaration

I _____________________________________ declare that the information given in this application is complete, accurate
and true. I also agree to abide by the Policies and Regulations of TEKAT Automotive College and make all payments due to
the College within the specified dates in respect of the programme enrolled. I understand that any information given falsely
or withheld will affect the decision of my application, and may result in my ineligibility for admission or enrollment.

Applicant’s Signature: ______________________ Date: ____________________

TEKAT Automotive College

No. 2, Jalan Hentian 5, Pusat Hentian Kajang, Jalan Reko, 43000 Kajang, Selangor, Malaysia.
Tel : 03-8733 8080 Fax : 03-8737 6886 E-mail : marketing@tekat.edu.my Website : www.tekat.edu.my