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AIMST UNIVERSITY 496741-P

Kedah Darul Aman, Malaysia No Perakuan Institusi: KPT/JPT/DFT/US/K05

For Office Use Only


Date Received:
Please affix passport size photograph here

APPLICATION FORM FOR ADMISSION TO FOUNDATION & UNDERGRADUATE PROGRAMMES


The following documents are required to support your application:

MALAYSIAN
1 Passport size photograph (affixed above) Certified true copy of Identification Card Certified true copy of all academic examination certificates (e.g. SPM / STPM / A-LEVEL)
Processing fee : RM 100* ( non-refundable) payable to AIMST SDN.BHD. REV ACCOUNT

INTERNATIONAL
8-passport size photographs Certified true copy of passport
(all pages including empty ones)

Certified true copy of all academic examination certificates


Processing fee : USD 150* (non-refundable) payable to AIMST SDN.BHD. REV ACCOUNT
Note: Please provide an official translation in English where necessary.

A PROGRAMMES PREFERRED
Select from the list below: st 1 : _____________________________________________ Intake*: ___________ 2 : _____________________________________________ Intake*: ___________ 3rd: _____________________________________________ Intake*: ___________
Foundation in Science (1 Year) (A 9160) Foundation in Science (Leading to Engineering)(1 Year) (A 9160) Foundation in Business (1 Year) (A 1652) Diploma in Nursing (3 years) ( PA 7212 ) Diploma in Physiotherapy (3 years) ( A 7211 ) Dip. in Electrical & Electronic Engineering (2 years) ( PA 7448 ) MBBS (5 Years) (A 9288) Bachelor of Dental Surgery (5 Years) (A 5321) Bachelor of Pharmacy (Hons) (4 Years) (A 6201) B.Sc. (Hons) Biotechnology (3 Years) (A 1654)

nd

B. Eng (Hons) in Electrical & Electronic Engineering(4 Years)(PA4271) BIT (Hons) Management (3 Years) (A 1655) BIT (Hons) Information Systems (3 Years) (A 1653) B.Sc. (Hons) Business & Marketing (3 Years) (A 4798) B.Sc. (Hons) Finance & Management (3 Years) (A 4797) B.Sc. (Hons) Management Information Systems (3 Years) (A 4799)

B PERSONAL DETAILS Title: Mr

Miss

Others ..

NRIC / Passport No.: Nationality: Race: Religion: Gender:

Name: (as in NRIC / Passport)

Correspondence Address:

Date of Birth: Marital Status: Single Home Tel No.: Mobile Phone No.: Email Address:

Male

Female

Married Others...
Fax No.:

C PARENT / GUARDIAN DETAILS i. Father / Guardian Identification Card No: Home Tel No: Office Tel No: Mobile Phone: Postcode: Employer: Occupation: ii. Mother Identification Card No: Home Tel No: Office Tel No: Mobile Phone: Postcode: Employer: Occupation: iii. Emergency Contact (Other than Parents / Guardian): Email Address: Monthly Income: Email Address: Monthly Income: Relationship ( if guardian ):

Name:(as in NRIC / Passport) Correspondence Address:

Name:(as in NRIC / Passport) Correspondence Address:

Name: (as in NRIC / Passport) Correspondence Address: Relationship: Home Tel No: Office Tel No: Mobile Tel No: Email Address: D ACADEMIC QUALIFICATIONS OF APPLICANT (please attach supporting documents) Institution 1. 2. 3. 4. 5. Qualification Year

English Language Proficiency Examination 1. IELTS 2. TOEFL 3. English 1119 4. MUET Year Grade

Extra Curricular Activities: Activities 1. 2. 3. 4. 5. Year Level Remarks

E SOURCES OF FUNDING Financial Support Self-financed Sponsored (please attach supporting documents) Others (please specify).

F ACCOMMODATION It is MANDATORY for ALL students to stay in the AIMST University Student Residence at Semeling Campus for the stipulated duration of their course.

G DECLARATION Parent / Guardian I,.hereby agree to pay all the required fees as stated in the fee structure and in accordance with AIMST Universitys policies. I also agree to the terms of AIMST Universitys fee refund policy *. . Signature of Parent / Guardian Applicant I declare that all the information stated in this application and all the documents that will be submitted upon registration is true and correct. I understand that AIMST reserves the right to change any decision regarding admission or enrolment made on the basis of incorrect or incomplete information. I agree to abide by all the academic and administrative regulations of AIMST University.

Date:

Signature of Applicant

Date:

* A copy of AIMST Universitys fee structure and refund policy will be given at the time of registration.

AIMST University will officially notify you of the outcome of your application. Please take note that submission of the application does not constitute acceptance into the university.

FOR OFFICE USE ONLY STUDENT RECRUITMENT DIVISION

Documents Complete Documents Incomplete Specify: FINANCE AND ACCOUNTS DIVISION


Application Fees Enclosed: Bankers Cheque / Bank Draft No. Cash : RM.. Others : RM..

Counselled by,

Signature Name: Date:

Signature Name: Date:

STUDENT ADMISSIONS AND RECORDS DIVISION Documents Complete Documents required (please specify).. Checked by :.. Date:.. .. Signature Name: Date:

Rechecked by :.. Date:.. Verified by :.. Date:..

SELECTION COMMITTEE/ DEAN Admission Status Feedback to Applicant Affirm Offer KIV Rejected Signature Name: Date:

................
Please return this form to:

STUDENT ADMISSIONS & RECORDS DIVISION

AIMST UNIVERSITY
Semeling, 08100 Bedong, Kedah Darul Aman, Malaysia.
FOR MORE INFORMATION PLEASE CONTACT
TEL: 604-429 8000 FAX: 604-429 8008

E-MAIL: choose@aimst.edu.my WEBSITE: www.aimst.edu.my