Scholarship Application Scholarship Application Form SECTION A : PERSONAL PARTICULARS AND COURSES TO APPLY *PLEASE SELECT THE COURSES YOU WISH TO APPLY: Bachelor of Science in Business Administration (4+0) (in collaboration with TRINE UNIVERSITY, USA) Diploma in Business Administration Diploma in Accounting Diploma in Finance Diploma in Information Technology Diploma in Visual Arts Diploma in Hotel Management Diploma in Tourism Management Certificate in Business Studies *APPLICANT’S FULL NAME : *I/C NUMBER : *DATE OF BIRTH (Day/Month/Year) : *AGE (YEAR) : *CORRESPONDENCE ADDRESS : *POSTCODE : *STATE : HOUSE PHONE NUMBER : *HAND PHONE NUMBER : *RELIGION : *RACE : *NATIONALITY : *EMAIL ADDRESS : HIGHEST EXAMINATION PASSED SPM / O-Level UEC STPM / A-Level DIPLOMA IN : DEGREE IN : *DATE OF COMPLETION (Day/Month/Year) : *SCHOOL NAME/COLLEGE/UNIVERSITY : Scholarship Application Form SECTION B: PARENT’S/GUARDIAN’S PARTICULARS *NAME OF PARENT/GUARDIAN : *IC. NO (NEW) : IC. NO NO. KAD PENGENALAN LAMA/POLIS : *RELATIONSHIP : *H/P NO. : TEL NO. : NO. OF CHILDREN : OCCUPATION : MONTLY INCOME (RM) : *CORRESPONDENCE ADDRESS : *POSTCODE : *STATE : COMPANY NAME & ADDRESS : POSTCODE : STATE : EMPLOYER’S TEL NO. : Scholarship Application Form SECTION C : ACCOMMODATION REQUIRED NOT REQUIRED MEDICAL CONDITION THAT REQUIRE THE ATTENTION OF THE COLLEGE (IF ANY) : SECTION D : DOCUMENTS NEEDED FOR PTPTN ONLINE APPLICATION *Please indicate items enclosed with this application : Certified copies of education certificates Certified copies of English tests (e.g TOEFL, IELTS) Photocopy of IC (both sides) Photocopy of IC (parents - both sides) Certified copies of examination results Eight passport-size photographs SECTION E : TYPE OF SCHOLARSHIP APPLIED Academic Excellence Scholarship Co Curriculum, Sport or community Services Scholarship Hardship or Financial Need Scholarship SECTION F : DECLARATION ON OTHER SCHOLARSHIPS *Have you been awarded any other scholarship? Yes No If yes, name the scholarship : Amount awarded : Duration of the scholarship : Scholarship Application Form SECTION G : DECLARATION & AGREEMENT I, the undersigned, declare that the particulars given by me in this application form are correct. I have also read and understood the Terms and Conditions of the award as attached. I agree to abide by the Terms and Conditions of the scholarship/financial assistance/bursary. I understand that the award can be withdrawn if any information given in this form is found to be incorrect. I understand and agrree that the personal information given herein will be used for verification and other related administrative purpose only.