PART L: Applicant Declaration

INTERNATIONAL STUDENT
APPLICATION FORM
I declare that the information provided by me in connection with the application is true and correct. I undertake to inform International University of Malaya-Wales immediately
of any changes in address, phone number and any other information provided by me in this application.

I understand that International University of Malaya-Wales reserves the right to vary or reverse any decision regarding admission or enrolment made on the basis of incorrect or
incomplete information. I agree to be bound by the Terms and Conditions of the offer to study at International University of Malaya-Wales.
Intake:
1. I hereby declare that all the statements given are true and every copy of certificate and attached documents are correct as instructed and that the IUMW have the right to
retract this offer and instruct me out of this University should any statement and certificates hereby are found not true.
2. I hereby authorize the University and/ or its employees to release my confidential information; including personal details, academic records, financial aid, discipline, and Programme apply for: Foundation Undergraduate Postgraduate Others
student financial account information to designated persons who have a legitimate educational interest in the records.
3. I agree to abide by the Statutes and Rules of the University, currently in force and as amended in the future, and that I must comply with orders and directions given by the
constituted authorities of the University. PART A: Personal Details (in block letters)
4. I have read and understood the information provided of tuition and other related fees and agreed to pay the required expenses and fees.
5. I hereby declare that I understand the above REFUND POLICY guidelines and I will fully accept and consent to the terms and regulations stipulated here to. I am also aware
that I shall bear the consequences as stated in the REFUND POLICY in the event of any non-compliance/non-adherence to the said POLICY. Surname / Family Name Salutation Dr Mr Ms Mrs

* Important Instructions: I have read and understood the above Given Name(s)
1. Attach relevant formal education qualifications (SPM/O-Level, STPM/A-Level, Diploma, Degree, Master and conditions and accept them in full.
other professional certificate e.g. ACCA, Members of BAR Council of respective country or others)
2. Withdrawal Passport No. Expiry Date Please affix a
a) Student must inform the Registrar in writing if they are withdrawing from a course of study. passport sized
b) Notice of withdrawal must be given two weeks prior to the commencement of the Programme. Race Malay Chinese Indian Sex Male Female photograph
3 Rules and Regulations
a) All students must abide by the University Rules and Regulations. Failure to do so may result in expulsion, Others Date of Birth
or a suspension.
b) Any criminal activities on the University premises will be reported to the relevant authorities. Religion Muslim Buddhist Hindu Marital Status Single Married
Signature
c) The University and its management will not be held responsible for any damages, losses or injuries arising
Christian Others Nationality
from the course taken at the University. Name:
d) The University's Disciplinary Board has the authority to suspend or/and expel any student behaving in a Correspondence Address
manner that affects the reputation of the University, the security of its staff and students, and its properties. Passport No.:
e) The University reserves the right to revise the University's Rules and Regulations within prior notice.
f) The University has the right to accept or reject any application without stating any reason.
Date:

Postcode City
PART M: Recruitment Office (for office use only)
State Country
Recruited by: Agent/Introducer:
Mobile Telephone

Name: Name: Facsimile

Date: Date: Company Stamp Email
Discount and Rebate (if any): Approved by: Permanent Address
(if different)
Name:
Date:
Postcode City

PART N: Faculty/Centre Verification (for office use only) State Country

Comment/Remarks (if any): Verified by:

PART B: Admission Checklist
Name:
Application status: To ensure you receive a quick response to your application, please enclose the following documents:
Date:
Approved Not Approved Faculty: Application form
8 passport size photographs with WHITE background (3.5cm(width) X 4.5cm(height))
PART O: Registry Office (for office use only) Curriculum vitae for MBA applications (if applicable)
4 pages (1500-2000 words) of Research Proposal for Master’s Degree (by research) & PhD applications
Admission Checklist Student ID: 2 copies of passport (all pages including blank pages), passport must have at least 24 months validity
A copy of Offer Letter 8 Passport-Size Photographs
Full Offer Conditional Offer Rejected Application processing fees of RM2,650 (registration and visa processing fee), via telegraphic transfer to INTERNATIONAL UNIVERSITY OF
Acceptance of Offer Letter Application form
Copy of Academic Transcript (If applicable) Copy of Passport (every pages) MALAYA-WALES SDN BHD: 8001297388, CIMB BANK Berhad (Branch: University Malaya, Lembah Pantai, Kuala Lumpur)
Copy of Academic Qualification Verified by: SWIFT Code: CIBBMYKL
Comment/Remarks (if any): Yellow Fever Vaccination Certificate and West African Examination Council (WAEC) Scratch Card and Serial Number for student from Nigeria
Name: No Objection Certificate (NOC) for student from Sub-Saharan and African Countries
Date: Pre-Medical Check-up
Certified true copies of academic certificates/transcript for the following qualifications:
PART P: Bursary Office (for office use only) O-Level A-Level CPU Diploma Bachelor’s Degree Master’s Degree Others
Certified true copies of English language proficiency for the following qualifications:
Student ID: Receipt No: Verified by:
GCE ‘O’ Level IELTS TOEFL CAE UEC CPE PTE Others
Comment/Remarks (if any):
Name: PART C: How You Get To Know IUMW
Date:
IUMW Website TV/Radio Commercial Brochures Billbord/Roadside Bunting Social Media
(Facebook/Instagram/Twitter)
PART Q: VISA Unit (for office use only) UM's Website Education Exhibition Newspapers School Visit/Counsellor
Word of Mouth Recruitment Agent SMS Blast Others
Comment/Remarks (if any): Verified by:

PART D: Accommodation
Name:
Date: Required Not Required
PART E: Programme Application (please (√) the programme you are applying for) PART J: Student Refund Policy
Centre of Language and Malaysian Studies Faculty of Business and Law This policy applies to All students (Malaysia & International) enrolled in ANY programme(s) offered by the International University of Malaya-Wales hereinafter referred to as the
“University”. To all intents and purposes, the application of this policy shall be limited to the context of fee refunds of any particular applicant(s).
Intensive English Programme Bachelor of Accounting (Hons)
IELTS Workshop Single Award Dual Award with University of Wales, UK Definitions Refund Rate
For the purpose of this policy, unless otherwise stated, The refund rate for programme tuition fee is appended
Bachelor of Business Administration (Hons) in Entrepreneurship
Centre of Foundation Studies the following definitions shall apply: as below:
Single Award Dual Award with University of Wales, UK
Arts Science
Bachelor of Business Administration (Hons) in Finance Term Definition Scenario Terms/ Guidelines Refundable Rate
Faculty of Arts and Humanities Single Award Dual Award with University of Wales, UK
Bachelor of Professional Communication (Hons) Refundable Fee • Library/ Resource Fee 1. A full refund of Programme Tuition
Bachelor of Business Administration (Hons) in Human Resource Fee is applicable and can only be
Single Award Dual Award with University of Wales, UK Management made, when:
Master of Arts (Professional Communication) Non-Refundable Fee • For local & international students:
Single Award Dual Award with University of Wales, UK
i) Registration Fee; a) The University is unable to
Doctor of Philosophy (Professional Comunication) Bachelor of Business Administration (Hons) in International Business ii) Administration Fee; conduct the programme;
Single Award Dual Award with University of Wales, UK iii) Insurance; and/ or
Faculty of Science, Technology, Engineering iv) Visa or
Bachelor of Business Administration (Hons) in Islamic Finance
and Mathematics • Rebate and/ or discount
Single Award Dual Award with University of Wales, UK • Exemption subject b) A Student Visa (applies to Full Refund
Bachelor of Computer Science (Hons)
(carried forward to next semester) International Student) is denied
Single Award Dual Award with University of Wales, UK Bachelor of Business Administration (Hons) in Marketing
OR withdrawn by the Malaysian
Bachelor of Information Technology (Hons) Single Award Dual Award with University of Wales, UK Government;
Withdrawal Form • To be obtained and filled by students who
Bachelor of Science (Hons) in Biotechnology Bachelor of Real Estate Management and Auction (Hons) are withdrawing from their studies.
Master of Science in Internet Engineering • The withdrawal needs to be approved or
Master of Business Administration
Master of Science in Project Management by Head of Respective Department.
Single Award Dual Award with University of Wales, UK • To submit necessary Documented c) A student fails to pass a particular
Single Award Dual Award with University of Wales, UK Doctor of Philosophy (Business) Evidence showing the grounds for course and is unable to re-enrol
Doctor of Philosophy (Computer Science) withdrawal. (applies to fees paid in advance).
Doctor of Philosophy (Project Management)
Study mode:
Full Time Refund Request Form • To be filled and submitted to Finance 2. 1st week to 3rd week 50%
Faculty of Health and Social Sciences Unit by students who requested for
Foundation leading to Bachelor’s Degree refund from the University. 3. 4th weeks onwards No Refund
Bachelor of Science (Hons) in Psychology
1 semester in the University of Malaya
Single Award Dual Award with University of Wales, UK
1 semester in the University of Wales, UK
Refund Procedure
1. ALL students requesting for a refund must fill and submit the Withdrawal/ Refund Request Form to the Registry Department.
2. ALL students are required to surrender their Student ID Card for cancellation to the Registry Department before the refund can be processed.
PART F: Academic Qualifications 3. A penalty of RM50 will be charged to the student or deducted from the student’s account if they fail to return the Student ID Card.
4. The University reserves the rights to use the Refundable Fee to offset the outstanding dues to the University.
Secondary School/College/University Qualification From (year) To (year)
International Students Only
A student is required to remit with IMMEDIATE EFFECT, the whole Programme Tuition Fee for Semester One (1) to the University upon Visa approval and/ or prior arriving
at University.

Payment of Refunds
1. The University shall take a minimum of Twenty-One (21) working days to process the refund upon receipt of the Withdrawal/ Refund Request Form and Supporting
Documentary Evidence.
2. A student’s refund will be in the form of a CHEQUE. The student will be notified to collect the cheque via letter / e-mail or any other methods determined as appropriate
by the University.
PART G: Next of Kin (family/guardian background) 3. Generally, the refunds shall only be made upon the STUDENT’S OWN NAME. In EXCEPTIONAL cases where refund must be made to a third party, a Student Authorization
Letter must be submitted together with the details of the third party’s account.
4. In ALL circumstances, students are advised to collect the cheque within Six (6) months from the date of submission of the Refund Request Form. Failing which, the refund
Name
shall be forfeited by the University.
Relationship 5. Credit balance in the student’s account due to overpayment shall be automatically carried forward by the University to offset against next semester’s programme tuition fee
if the student does not request for a refund via the Refund Request Form.
Correspondence Address

PART K: Privacy
PRIVACY NOTICE: The infomation requested is used for our assessment of your suitability to programmes offered, for administration, management and support services
Postcode City (including, accommodation, transportation, immigration services), assessment and analysis, programme promotion and which may be disclosed to our service providers, and
agents, the International University of Malaya-Wales (if applicable) for these purposes or if required to be disclosed to regulatory or statistical authorities, agencies or bodies or
State Country (where applicable) to the foreign authorities, embassies or consulates of an international student’s home country. The information requested is necessary for the above purposes
and your failure to provide the information, or providing inaccurate information may result in us not being able to fulfill the purposes above and could result in rejection or delay
Mobile Telephone of your application.

If your application is rejected, we will keep your information for a reasonable period according to legal requirements, and also for administration and marketing purposes and
PART H: Financial Arrangements may contact you on any promotions.

If you do not wish us to contact you for this purpose, please tick (√) here ............................................................................
How do you expect to be financed during your studies?
Note: if you later wish us not to contact you, please send your request via email to marketing@iumw.edu.my ....................
Self Finance Scholarship Sponsorship Other
If your application is accepted, all information provided by you will become our student record and will be necessary to be retained by us for the purposes as stated in our letter
If you are being sponsored, please provide an official letter, name and address of the sponsor. of offer to be later issued to you. Further, your information may be disclosed to be person which you specify below and also to such persons mentioned in our letter of offer to
be later issued to you.

You have the right to ask for a copy of the information we hold on you and to correct any inaccuracies in your information. Please refer to the Registry to submit your request.

PART I: Working Experience (if applicable) Personal Data Protection Act 2010: Persons authorised for disclosed of personal information
In the processing of my application, i hereby authorise IUMW to disclose my personal data (including sensitive personal data) to the following persons:
a) My parents
Name & Address of
Position Held From (year) To (year) Responsibility b) My spouse (if applicable)
Employer c) Other persons (please name and indicate relationship)

Name: ................................................................................................................................................................ Relationship: .....................................................................