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Fill in your details to schedule for a counselling session.




ONLINE APPLICATION
The information on this online application form is collected for the purpose of processing your request.


1. Personal Details

Gender*

15/02/1996

2. Academic Record

( SPM / UEC / STPM / O-LEVEL / ETC )

Result Type : *

Subject list : *

Add

( certificate / diploma / degree / etc - if any )


3. INTAKE / PROGRAMME APPLY

Preferred Intake : *

Campus : *

programme applied for : *

4. Medical Details

Asthma
Deaf / hearing impairment
Epilepsy
Dyslexia
Require personal care support
Wheelchair user / mobility difficulties
Mental Health difficulties
Color Blind
Others
No known disability , health or special requirement
* I declare that all the information I have entered on the online application form are correct.