AKADEMI LAUT MALAYSIA (MMASB) APPLICATION FORM ... https://forms.office.com/Pages/ResponsePage.aspx?id=6RUXG8Pk6...

AKADEMI LAUT
MALAYSIA (MMASB)
APPLICATION FORM (NEW)
(BORANG PERMOHONAN ) 2023

Please complete this section before you submit the form.

(Sila lengkapkan bahagian ini sebelum anda menghantar borang)

1. NAME (IN FULL)

*
(NAMA PENUH)

WAN EUSOFF A'DANI BIN WAN ARIDI

2. Please choose ONE (1) only (Sila pilih satu kursus sahaja)
Single, aged between 18 and 25 years of age *
(Bujang, berumur antara 18 dan 25 tahun)

Diploma in Nautical Studies (DNS)

Diploma in Marine Engineering (DME)

Deck Rating Programme (SKM) 10 Months

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AKADEMI LAUT MALAYSIA (MMASB) APPLICATION FORM ... https://forms.office.com/Pages/ResponsePage.aspx?id=6RUXG8Pk6...

Deck Rating Programme (STCW) 6 Months

Engine Rating Programme (SKM) 10 Months

Engine Rating Programme (STCW) 6 Months

Diploma in Maritime Management (DMM)

Diploma in Maritime Services (DMS)

Diploma in Maritime Transportation and Logistics (DMTL)

Diploma in Maritime Business Administration (DMBA)

3. I am from:
*
(Saya dari):

Science Stream (Aliran Sains Tulen)

Technical Science Stream (Aliran Sains Teknikal)

Commerce Stream (Aliran Perdagangan)

Other Stream (Lain-lain Aliran)

Arts Stream (Aliran Sastera)

4. NRIC (as per the following example: 901010-04-9999) OR

PASSPORT NUMBER (FOR FOREIGN APPLICANTS ONLY)
*
[NRIC (seperti contoh berikut: 901010-04-9999) ATAU
NOMBOR PASPORT (UNTUK PELAJAR ASING SAHAJA)]

051217-05-0077

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AKADEMI LAUT MALAYSIA (MMASB) APPLICATION FORM ... https://forms.office.com/Pages/ResponsePage.aspx?id=6RUXG8Pk6...

5. Email Address
*
(Alamat e-mel)

waneusoff17@gmail.com

6. Address
*
(Alamat)

A7850 LORONG ALOR AKAR 25, PERKAMPUNGAN TERATAI

7. Postcode
*
(Poskod)

25250

8. Town/City
*
(Bandar)

KUANTAN

9. State
*
(Negeri)

PAHANG

10. Country
*
(Negara)

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AKADEMI LAUT MALAYSIA (MMASB) APPLICATION FORM ... https://forms.office.com/Pages/ResponsePage.aspx?id=6RUXG8Pk6...

MALAYSIA

11. Mobile Phone (as per the following example: 010-1234 5678)
*
[Telefon Bimbit (seperti contoh berikut: 010-1234 5678)]

012-6271079

12. Guardian Mobile Phone ( as per the following example: 010- 1234 567)
*
[Telefon Bimbit Penjaga (seperti contoh berikut: 010-1234 5678)]

012-6644932

13. Date of birthdate

*
(Tarikh lahir)

12/17/2005

14. Age
*
(Umur)

18 TAHUN

15. What gender do you identify as?

*
(Jantina)

Female/Perempuan

Male/Lelaki

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AKADEMI LAUT MALAYSIA (MMASB) APPLICATION FORM ... https://forms.office.com/Pages/ResponsePage.aspx?id=6RUXG8Pk6...

16. Please attach your SPM result in .pdf or .jpg format | Sila muat naik
keputusan SPM dalam format .pdf atau .jpg .

Attached it to this link & stated UPLOADED once done at the answer *
column. (Sila lampirkan ke pautan ini dan nyatakan TELAH DIMUAT
NAIK setelah selesai di ruangan jawapan.) - https://bit.ly/3ZXUu2Z
UPLOADED/DIMUAT NAIK

17. Citizenship
*
(Kewarganegaraan)

MALAYSIA

18. Religion
*
(Agama)

ISLAM

19. Ethnicity / Race

*
(Bangsa)

MELAYU

20. For International student, please upload your certificate at the link
provided (Bagi pelajar antarabangsa, sila muat naik sijil anda pada pautan
yang disediakan) - https://bit.ly/43ztXfx

1. Cadetship entry requirement - School exam certificate equivalent to UK

GCE O’ Level with strong credits in Mathematics, Science/Technical, 3
other subjects and strong credits in English* language.

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AKADEMI LAUT MALAYSIA (MMASB) APPLICATION FORM ... https://forms.office.com/Pages/ResponsePage.aspx?id=6RUXG8Pk6...

*Compulsory to have IELTS 5.0 or TOEFL Essential (Online) 7.5 or TOEFL

IBT 40 or CEQT (154) or ELS (107) or PTE (47) or MUET (Band 3) *

2. FABM entry requirement - Score 5.0 for International English Language

Test System (IELTS) OR TOEFL Essential (Online) 7.5 OR TOEFL IBT 40
OR CEQT (154) OR ELS (107) OR PTE (47) OR MUET (Band 3)

ONCE UPLOAD PLEASE ANSWER BELOW: UPLOADED

UPLOADED

N/A

21. I confirm and certify that the information given above is true. I also agree
that ALAM has the right to reject my application if the information
provided is found to be untrue or false.
(Saya mengesahkan bahawa maklumat yang diberikan di atas adalah
benar. Saya juga bersetuju bahawa ALAM mempunyai hak untuk menolak
permohonan saya jika maklumat yang diberikan didapati tidak benar atau
palsu.)

AGREED/SETUJU

22. All applicants who use this form agree by giving consent that Malaysian
Maritime Academy Sdn Bhd (“MMASB”) shall have the right to collect,
process and/or use Personal Data relating to the APPLICANT
(Semua pemohon yang menggunakan borang ini bersetuju dengan
memberikan persetujuan bahawa Malaysian Maritime Academy Sdn Bhd
("MMASB") berhak untuk mengumpul, memproses dan/atau
menggunakan Data Peribadi berkaitan dengan PEMOHON.)

Please note that this Notice supersedes the Previous Personal Data Notice
and will be effective from the moment you shared your personal data to
MMASB for your enrolment purposes. *
(Sila ambil perhatian bahawa Notis ini mengatasi Notis Data Peribadi
Terdahulu dan akan berkuat kuasa dari saat anda berkongsi data peribadi
anda kepada MMASB untuk tujuan pendaftaran anda.)

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Click here for full notice and FAQ’s (Klik di sini untuk notis penuh dan
Soalan Lazim (FAQ)) -
English Version - https://bit.ly/402Vdjb
Bahasa Malaysia Version - https://bit.ly/3ZZ6gtZ

Agree, please submit my registration. (Saya bersetuju, sila

hantar pendaftaran saya.)

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