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= required fields
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Miquelon
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*
Country of Citizenship
Choose
Albania
Algeria
Andorra
Angola
Argentina
Armenia
Aruba
Ascension Island
Australia
Austria
Azerbaijan
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bhutan
Bolivia
Bosnia
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African
Republic
Chad
Chile
China
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
(Ivory Coast)
Croatia
Cuba
Cyprus
Cyprus
Czech Republic
Denmark
Diego Garcia
Djibouti
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland Island
Guadeloupe
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Japan
Jordan
Kenya
Kiribati
Korea (North)
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mexico
Micronesia
Moldova
Monaco
Mongolia
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Puerto Rico
Qatar
Reunion
Romania
Russia
Rwanda
Samoa (U.S.)
Samoa (Western)
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Korea
Spain
Sri Lanka
St. Helena
St. Pierre and
Miquelon
Sudan
Surinam
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tanzania
Thailand
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Vanuatu
Venezuela
Vietnam
Yemen
Yugoslavia
Zaire
Zambia
Zimbabwe
* Date
of Birth
* Sex
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Male
Female
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Status
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Married
Single
Divorced
Other
* Telephone
:
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:
*
Email Address :
* Qualification
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Secondary
Certificate
Professional Cert.
Diploma
Higher Diploma
Associate Degree
Degree
Master
Phd
Others
* Passport
No/IC No
Expiry
Date
After you have submited this online application
you need to send us the following documents
-Certified
copies of educational certificates
-Certified
copies of examination results
-Certified
copies of English tests
-Six
passport size photographs
-Photocopy
of passport(all pages)[for international students]
if Malaysian, Photostat of IC(Both sides)
How would you like to send the above documents
to us ?
I would like to send through *
Choose
Post
Agents
Fax
Email
Direct
If you want to send the above items through
Post
or Direct:
Putra International College-Troy University, USA,
Lot 1838 Ayer Keroh, 75450 Melaka, Malaysia.
Tel: (606)231-6826.
Fax
Fax:
(606)231-7537
email
Study@iputra.edu.my
The application and registration
fees of RM 500(Malaysian Students) or USD 300(Foreign
Students) must be payable to Putra International College.
Declaration
& Agreement
1.I will be solely responsible, assisted
by the institute with respect to the application of my
visa.
2. If my application for a student visa
is rejected by the malaysian authority, the US300 registration
fees shall not be refunded to me.
3.In the event that I am granted a visa
to study in malaysia-and upon the completion of my studies
at the Institute, Institute Putra, upon my request, will
assist me in my application for the necessary visa from
the foreign embassy of the country selected by me to further
my studies.
I acknowledge that a student visa may be difficult to
obtain and that Putra International College will not be held responsible
in the event that the relevant foreign embassy rejects
my application for a student visa to enter the country.
4.I declare that the information on
this form is complete,accurate and true, and I agree to
abide by the rules and regulations of Putra International College.
I understand that any information given falsely or withheld
may adversely affect the Institute decision on my application.
Note :Students are not of partner/affiliated university
students UNTIL they havesubmitted the application Form(over)
to partner/affiliated university -and are admitted by
the partner/affiliated university
*
I
Accept the Agreement
I dont Accept the Agreement