« Ba creny APPLICATION FORM Sea) Name of Applicant Salutation Mr GMs aM Others (as per MyKad / Passport) NRIC / Passport No, Expiry Date Race a Malay a Chinese Indian Sex 5 Male a Female 0 Others Date of Binh ety Religion o.Muslim Buddhist c Hindy = Marital Status Single co Married 1 Others 2 Christian Others Nationality Place of Birth Correspondence Address City re Postcode Country a State es Telephone Se Mobile Se Foctimile pa Email Permanent Address (i different Postcode cose Cy ee State es Country Paar Parent /Spouse / Guardian Name ee NRC / Passport No, Relationship Father o Mother Spouse oOhers Correspondence Address Mobile Telephone a Occupation Office Income Per Annum Emailee ee Foundation 8 Commerce © Science Corffcates © Corfficate in Business Studies Diploma © Diploma in Business Administration 1B Diploma in Accounting 1 Diploma in Early Childhood Education 1 Diploma in Hotel Management 1D Diploma in Tourism Management © Diploma in Culinary Arte © Diploma in Restaurant Management © Diploma in Medical Laboratory Technology © Diploma in Information Technology © Diploma in Electronic and Electrical Engineering Undergraduate 1G _BA (Hons) of Business and Management (2+0}(3+0) 1G BA (Hons) Business and Marketing Management (2+0}{3+0) & BA (Hons) Accounting and Finance (240)(3+0) 1 BA (Hons) Early Years Education (2+0}{3+0) 12 BSc (Hons) International Tourism and Hospitality Management (2+0}(3+0) © Se (Hons) in Computing (240)(3+0) 1 BSc (Hens) in Business Adminisiration (Global Business) (4+0) © BSc (Hons) in Paychology (4+0) © BEng (Hons) Electronic and Electrical Engineering (2+0)(3+0) 12 BEng (Hons) Mechanical Engineering (2+0)(3+0) Mede of Study © Full Time 0 Parttime Intake Date: Olhers ifnot stated above :eee Secondary School / Insitution / University Qualification From (year) | To fyear) Part D : English Language Proficiency ‘Applicants who wish fo study programmes tought in English must meet the English language requirements for individual programmes. Pease indicate your highest level of English proficiency and the Grades obtained. OGCE ‘O' Level WETS O TOEFL 0 MUET 0 Ohers: ‘Company Position From (year) | To fyear) eee How do you expect fo be financed during your studies? Self Finance OPTPIN GScholarship CEPF Sponsorship o Others: Ifyou are being sponsored, please provide the name and address of sponsor. IF you ore not being sponsored, please provide « lator Indicating your abilty Yo finance your edvetion. ee ee To ensure you receive a quick response to your application, please enclose the following documents: 10 Include 2 copies (8 copies for international student) of colour passport sized photographs © Include eerfcate copies ofall academic qualifications (school, college, university) 1 Include SPM/A-Levels/STPM/or equivalent quali © Include 1 photocopy of Identification cord © Include photocopy of passport (3 fll set) “only applicable for International student Remark: *Compulsory Documents Note: Application for Bank loan / PTFTN Loon / EPF must be made at least one month prior to the orientation datoPart H ry lt SBN. og eg OE Stan da PE 2 ee ete SE avaen Sot ace andar nace tem erento ey Sipe ntn tan tate, — 1 1 1 1 1 1 316 317 38 43 Stadt mut ish Ei Calags Png wih datos peas bee persian’ toda! mon Soy Ol regaieen Kee nine ip fel oes, Stade! ru sl the Tat inact on Skt of Clas dole of he course rein with SEG Folureto poy the Ist natament on Sat of Clos date wi coune fhe suet tobe barred from lon collecting tidy materials registration of excrns and/or ‘ther faites and services of SEGi College Penang, ota tring sonion ro coed Discount and Promotions Full Payment Discount on 5% enlement is ald fr fll course fees paid before or on the date ofthe Start of Clas Sod aera / hail omen unless the fill course fee's payments received by SEGi befere or on the date of Slr | ‘Al premotiond rates on fee cr diccuets ae to tke fic! onthe fl course fap isclment payment Should the sent wthckow before completion ofcourse, fe rebcte cr duceutstpucted m louse £3 bow shall no longer be vid cr avalable, Withdrawal and Termination Ika aunt wishes wi fon hi/her course of tc, he tudent mst fish SEGi Cllge Fanang wih a wihdrawalnetca/fom, tein fo fan be smite The Buran Department. ‘A wahdrowa hag nt wien rm, od nl abated o The Bursary Deporte shal be deemed invalid and wnt be eteined ‘Tha student is not dlowed to backdate the withdrawal notice / form. Foliage atend done: before subnision of he withdrawal later/orm shall be regarded as absence and not wihdrawl on hose day of absensa, ‘ny reguest for relia upon wirowal Pogronine mu! be mode wihin 60 day rom sobmiin of he wihdrowa tice / frm: Korn eee / ero wih ceed ere he earemmonne fn ee ete of rgpenne, «6A rbd fe en Fen gels ola ypc pwn che dn sana o son lh acon ogra ncn con FFatwiten noice / form st withdrawals received Sie he commencement of he sks date no rekind wil b given forthe Tution Fees fr the ‘ui aren bl rind wal bm gn xy Toon Fos neg smerny vc ation Fens os ban pol by ow too ing net more hen 50% of te fal Totton irene enh "Conse = S357 Sain cite apes as ach rien, |b, ois, arto, PO ond Semen op, npn doy cer nales fms ones ested noob hw be soteind sed ire yor Eud el gen ey fo or pty he Testu Deporte knee to Sete! won enplatn cl wihewel cf toome Rend ef Resse Depot cloned ae deducing charges of damage yee vey, Compr ib on he line revel SC Clee Peng, athe rd poy Sanogeby so wich anda Sco Glogs Penang abl ry eng es ed by sd! Ey Calge Penang Fora fms of reads, tre Soden! mat lp the Rend Form and ctoch wih engin recip, sen ID card ond fe payment card the Side veatedte wits alter asing chet elu chsecapt end vba rey Depart Al end rane wl be promod ie raquied twee recap ond ude Barry Departs, Al equed apa lerance nt po odtnding fen some by ser ms Pes ‘MTree be dined by hs sed wn 2 dae ee whoa er mination of th core ein the ce wher EPF/loon cheque ig alaosed ater withdrawl of temination of re cours, to be claimed 60 days hem he disbursement ofthe EFF er the Loon. Fore to do so potest ica eos os — sy Sie Ko Monte sland ich cs, 82 smd nde so ofthe cmour recehed achngin ne cr ort ont ew ale resign cwpad sen opie ny oh Gh BSS Sieg thee ahve, SEG: Cage wil held cl os unl competion ofthe cours of sy wth ECA Clg: org Sar sed ln cog bese cles doe EF ond lon rns oo ‘hen due io SEG Clog Penong coven ‘whole course fee and not per instalment or semester. Lean Calle . 1) Royo dam For nn mnt cot wee Coe Fu and ain Few of SEG Calg Poa beng ere ‘Al rend ke leg wih 60 days om he dete SEG ColegePenong'sBursry Departmen recsvs the Refund Form fr processing, Rafd fo proceeds fm loane/ EF - Whore func fencer fen. rk dab for duo wihrowal rm cours of sudo othe ‘proceeds ofthe Bank loan / EP, all such rehnds should be made fo the banks / EPF excep! kx the partion where he student have made pore ere. 1 Be crn of nonpmmt e lte poner eo fs SE Cela Pong ho he el wth ther ao nisrative charges on each day of dou | chargel in accordance to Clause 5 below and/or to cherge o charge pire charges on ach Sy {ate paymect charge) to Clause below and/or te charge {2 bathe Suda! rom wing SEGi Collage Penang’ foities and/or atoning losses or examinations andr withelding submission a len eter Henney rel plo on ge services ends ick Sch ccton 08 dams epproprtae; fone pd te Sc to cnc cf ncn Sr aa herder uhorties for 1, lend hyena mig pen natin et prin awn eh TOS tallesbersning sepoune a Yaris poycle bye sedeee 1015601 Calne Panrg midway in he rr Sd sal berenredic a te lel nad oe Se si - Sec iees as ye aed Sd Calg Pee Lae ots Uy sm nila Soa ce aye ek coe nog be trie ive ee Being tere reres hr 1d ll couse fees payable to the collage fr without pri vena nights omen lcs 5 — Ley cece rake ake ee ee ae er ee ae ees tragic onpereeacs eahieiieare asin Demme” Department The Student is not oll ‘doe the Transfer Form, Transfers only effective if the Bursary has received the ote sce cd can fe pon coconut Fer ond eri tno ep enor ly at ee ise ee ee ee ees trode tpl cd si ery lost etn ors pint os ere Seine creer puma teen care TRS Taig doo le be slored ese ee oe44h lew rn er Snes SE Unety ad Col op by go he eal Far cvailoble ot Bursary Deparment. The Student snot ellowed to back date fe wens allectve “ay Sapa ‘ctreceved the Troner Form and cl ursanding ve hom previous course i sdled. Region fee nt Wonderable fo chr SE Inststone onder he SEG Unierty ond Coleges group e J 3 # i se - s2 Richest dear pen di ey pra cr ee ton eres eae st oe ieranest Ral tere bee bomen —— Sere gee gemma ee fata Sane rare ee free eae Soy Skool peta Form balre the foes dues date / deadline, he / she wil be chorged the adninistatvechorge fr late payment of RMT.O0 eon ne on atetenpmenme ny 53 The dat ho ng er sud on / EF mes py minimum of E00 monty ntalna’ or he acu ok ising notly Sek dey woh ln owen chance deo Cryo a 9p dy be lg Sy Sandy ond Pl eid 7 aide itthouto sre being chee te saad he inde ay cpp Ee valet undo the lt stilted in Clouse 5.2 above. se fect SEG Coleg Ps Shudents given 3 months ehictimateniiaiaaas beta hatrreneten oxen era Ger Cl hed eon or tal dared ete he 3 mon pd, ne sete poy a ote fouse fees up fo the curent month occerding to the normal inslaimert plon of the cours Fer Studeis applying for EF. 0 copy ol EPF wihdrawal See ic lees furnished fo SEG: Collage Penang. Sten ae 7 EF baled en separ port ba, te ent wpe poy hi / br cree pth rr enh ‘the normal instlment cour. 5:5. The Suey mt veloc fe cre feasting ke ony xonintic clacton of decks /rensph Flag ed othe sat will not bellowed ost fer he exams or collect his / her wonscript 5.6 All shdens must pay their exarinction fees before siting for woms. (Student who applied for sy loon / EPF which includes exom fos wil ‘ged pohis ie erominton oe low te oan 7 EF pera 57 Panang os he rgho wil suns cenit, ation, rei ranscripts and bar the students fom Ghendng caus ote che Reorenenedaprocne by 86 Cage Penang wil es emt 5.8 Anyertor or omision inf schecles given fo sents (ony) oe excoped $, Resend teed rd mes Cnr 1 lice com wi ond ie SE Celgene Bod Rego ee ho Teme rd Coons crn hea bh SA etal gercamphonc by he Sent oy Penang’: Res and Regulations or Terms and Condiions contained herein, SEE Caloge Fong hl unre tights take wchotendetoud necouary Spats Soden Where: the Shident shal be required to comply with the Rules ond Regulations Terms ond Condtions ofthe Partner University in which the Student is registered wit, via SEG! College Penang. 7. Communications 7. filetrs rnp, nics, nice nd cher commonicion the det hare opi, concerned nh ‘den wel, rege sends wos sch expres Yondy wonkzn,gtdone wtbotos or rec of Seda “any cam a et oe ved dare Ujena rte be el ha hs ote Ct Fon og eo credo 5 CLF Ra Be deeced io how been reconed Gy tho dest fond shore ppeotte by ohcn) opon delivery delivered by hand to the student ed, hare apical fo fhe Concer Pon or win fro) isting dpe fancy po 7.2. Where appropriate or | expeditions, SEGi Collage Penang may correspond with | and Concern Person) by way of electronic mail. Privacy 8.1. The processing of perscnal data willbe n accordance fo SEG's Privacy Policy and Stents must fake note ofthe SEG’ Privacy Notice and Pankey ele rd at wand edbam ee ont Peer Poe. selene - Hon Commencernnt 91 nih ev et SECs Colage Penang it fhe opinion fa inet vibe for wher rotons, nceing minimum ln in, be conan ry posed course, SEGiCaloge Pang rare height to carmence ha cure cin ch cn er fos pid shale roknded interest 10. Variation 10.1 SEGi Callage Penang has the right 1 change those Terms and Conditions witht pric notice \ declare et he inlernaton proved by mn conacton wth the oppicaten sre nd crc | under one SEGY Cage Panang immediatly of any changer in adcrons, phone nutar and Gny cher tomato provided by men ti opin. [tnd ha 2 Sige Penn era be ie yore GEasEy ge Nel niaie emanate eee incerrect or incomplet norsaon, | eyre tbe bound by fre forms Gnd Condons of hs fier sides ct SEG Cologe Penong, ‘Applicant Signature aon snd the reals rmsript/comespondes DToMe Only ToMy Guardians Date =| have read the Privacy Notice above and consent fo the collection and processing of my personal data in the aforesaid manner. Saya telah membaca Notts rivas! di atss dan bersetyy terhadap pengumpulan dan pemprosesan data peribadi saya mengikut cara yang dilsrangkan. Name/Nama NRIC/Possport No. No. kad Pengenclan/No. Posspot Signature/ Tandatangan Date/Tarikh : Parental/Guardian’s Consent fonly if applicn is below 18 yaar od ertebjvantbv Bopa/Penjage (ka pemchon dibawoh8 ton) | have read the Privacy Notice above and consent fo the collection and processing of my child’s/ward's personal data in the ‘oforesald manner. Saya telah membaca Notts rivas! di aizs dan bersetyy terhadap pengumpulan dan pemprosesan data peribadi anak/anak jagaan saya mengikut cara yang dlterangkan. Name/Nama NRIC/Passport No. Nia: Kaa Regu, Rept Signature of Parent or Guardian/Tandatangan Ibu/Bape atau Penjaga Date/Tarikh PRIVACY NOTICE: | understand that SEG! will uso this Information forthe purpose for administration and marketing purposes and ‘may be shared withthe SEGI University Group and to its service providers. | give my consent fo the processing of the data. INOTIS PRIVASI: Saya faham bahawa SEGI akan menggunakan maklumat Ini bag! fjuan pentadb iran dan pemasaran don borkomungkinan akan dikongsi bersama Kumpulan SEGI Unversit dan juga pembekal perkhidmatannya. Saya dengan Ini member! persetyjvan bog! pempreseson data peribad! trsabut. Name/Nama Signanxe/Tandatangan Date/Tarikh = Parental/Guardian’s Consent fonly i applican is below 18 years oli}/Perseujvan Ibu Bapa/Penjoga (ka subjak data dibawah18 thon) | have read the Privacy Notice above and consent o the collection and processing of my chilt’s/ward’s personal data in the ‘forosaid manor. Saya falah membaca Nets Privas! di ates dan berselyu ferhadap pengumpulan dan pemprosesan data peribad! anak/anak jagaan saya mengikut cara yang diterangkan. Name/Nama NRIC/Passport No. No. Kad Pengenalan/No. Passport Signature/Tandatangan Date/Tarikh : Note: Details of SEGI’s Privacy Policy Is available at wwwsegl edu. my] [Nota: Butiron lanjut mengenal Dasar Peivas! SEGI boleh didapatt melalv!laman sesawang www. sagl.edu. my]FOR OFFICE USE ONLY Programme Applied ‘Mode of Study 1 FullTime a Partfime | Inthe Payment Mode © PIPTN loan © Selfpayment 2 Sponsorship 0 EPF 1B Registration Fee 1G Access Deposit 1D Security Deposit 0 Lab Fee 10 E-Resource (Full Name) Others 1 External Pariners! Application Fee International Student 1 Tuifion Fee (Full Payment / Instelment) 1 Visa Application OEMS Fee 1 Visa Processing Fee 1 International Student Admission Fee Counselled by: Approved by: Name : Nome: Date: Date: 10 Full Offer 2 Conditional Offer Rejected Registry’s Remark and Recommendations (Authorized Signature} Nome: Date: Note: “Acknowledge Approval Skden!Enty Requirement Registration Date: ‘Commencement Date: Processed by: Date: