AIMST University Application Form PDF

AIMST UNIVERSITY 496741-P AIMST-SOP-07-01_FRM001 Kedah Darul Aman, Malaysia No Perakuan I...

AIMST UNIVERSITY 496741-P AIMST-SOP-07-01_FRM001 Kedah Darul Aman, Malaysia No Perakuan Institusi: DU010(K) For office use only Please affix passport size photograph here Date Received: APPLICATION FORM FOR ADMISSION INTO FOUNDATION & UNDERGRADUATE PROGRAMMES The following documents are required to support your application: MALAYSIAN INTERNATIONAL 1 Passport size photograph (affixed above) 4-passport size photographs Certified true copy of Identification Card Certified true copy of passport (all pages including empty ones) Certified true copy of all academic examination Certified true copy of all academic examination certificates (e.g. SPM / STPM / A-LEVEL) certificates Processing fee : RM 100 (non-refundable) Processing fee : USD 150 (non-refundable) payable to “AIMST SDN.BHD. REV ACCOUNT” 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 : _____________________________________________ Foundation in science Intake: ___________ 1 year Full time / Part Time nd 2 : _____________________________________________ Intake: ___________ Full time / Part Time rd 3 : _____________________________________________ Intake: ___________ Full time / Part Time  Foundation in Science (1 Year)  MBBS (5 Years)  Bachelor of Electronic Engineering (4Years)  Foundation in Science (Leading to Engineering)(1 Year)  Bachelor of Dental Surgery (5 Years)  Bachelor in Nursing Science (Honors) (4 Years)  Foundation in Business (1 Year)  Bachelor of Dental Technology (4 Years)  Bachelor of Computer Science (3 ½ Years)  Diploma in Nursing (3 Years)  Bachelor of Pharmacy (Hons) (4 Years)  Post Basic in Critical Care Nursing  Diploma in Physiotherapy (3 Years)  B. (Hons) Business & Marketing (3 Years)  Post Basic Basic Renal Nursing  Diploma in Business Management (2 ½ Years)  B. (Hons) Finance & Management (3 Years)  Certificate in Emergency Medical Technician  Diploma in Finance (2 ½ Years)  Certificate In Healthcare Assistant (HCA)  BSc.(Hons) Accounting and Finance (3 Years)  Diploma in Biotechnology (2 ½ Years)  Certificate in Dental Clinic Assistant  Bachelor of Physiotherapy (Hons) (4 Years)  BSc. (Hons) Management Information Systems (3 Years)  Dip. In Electrical & Electronic Engineering (2½ Years)  BSc. (Hons) Bioinformatics (3Years)  B. Eng (Hons) in Electrical & Electronic Engineering (4  BSc. Biomedical Sciences (4 Years) Years)  B – PERSONAL DETAILS ) Title: Mr  ✓ Miss  Others …………….. NRIC / Passport No.: 050525 - 07 - 0614 Name: (as in NRIC / Passport) Nationality: Malaysian Cheah Wen Ye Race: Chinese Religion: Buddhist Correspondence Address: 3 Date of Birth: 25 - 05 - 2005 Gender:  Male ✓ Female BLK 21 - 3 - 12. Ting Kat Paya Teru bong , 11060. Air Itam , Pulau Pinang.  Marital Status: V Single  Married  Others………... Home Tel No.: - Place of Birth: Penang Mobile Phone No.: 016 - 4288217 ( Email Address: [email protected] Size: S/M/L/XL/XXL REV_1 (2022)  AIMST-SOP-07-01_FRM001 C – PARENT / GUARDIAN DETAILS i. Parent / Guardian Name:(as in NRIC / Passport) Suan Identification Card No.: 741220 07 5580 Ooi Ching - - Correspondence Address: BLK 21 - 3 - 12 , Ting Kat Paya Teru bong 3 , Home Tel No.: - Pulau Mobile Phone: 016 4282217 11060 Air Itam Pinang -. , , Postcode: 11060 Email Address: - Employer: Island Hospital Monthly Income: RM 2500 Occupation: Nurse Relationship ( if guardian ): ii. Emergency Contact (Other than Parents / Guardian): Name: (as in NRIC / Passport) Cheah Tek soon Correspondence Address: Relationship: Father 3 BLK 21 3 12 Ting Kat Paya Teru bong - - , , Home Tel No.: - Pinang 11060 , Air Ham , Pulau. Mobile Tel No.: 013 - 5332368 Email Address: - D–SURVEY QUESTION How did you come to know about AIMST University? ( You may tick () in more than one option) Agent Newspaper Advertisement AIMST Website Magazine Advertisement Banner Social Media Billboard Flyers Advertisement Education Fair Radio/Television Family/Friends School Counsellor Other Websites ✓ School Seminar Telemarketing E – ACADEMIC QUALIFICATIONS OF APPLICANT (please attach supporting documents) Institution Qualification Year 1. 2. 3. English Language Proficiency Extra-Curricular Activities: Examination Year Grade Activities Year Level Remarks 1. 1. IELTS 2. 2. TOEFL 3. 4. 3. English 1119 2023 A - 5. 4. MUET REV_1 (2022)  AIMST-SOP-07-01_FRM001 F – ACADEMIC RECORD Are you a former student of AIMST University?  Yes, please provide your Student ID number ________________ ✓ r  No, Have you applied to AIMST University before this?  Yes  No G – SOURCES OF FUNDING Financial Support ✓ Self-financed Sponsored (please attach supporting documents) Others (please specify)…………. H – 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. I – DECLARATION Parent / Guardian Suan Ooi Ching I,………………………………………………………………….hereby agree to pay all the required fees as stated in the fee structure and in accordance with AIMST University’s policies. I also agree to the terms of AIMST University‘s fee refund policy *. § ………………………………………………. Signature of Parent / Guardian 16/6/23 Date: …………………… 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. ' any ……………………………………………… Signature of Applicant 16/6/23 Date: …………………… * A copy of AIMST University’s fee structure and refund policy will be attached together with the offer letter. AIMST University will officially notify you of the outcome of your application. Please note that submission of the application does not constitute acceptance into the university. By submitting your personal data to us, you consent to us collecting, using, disclosing and processing your personal data in accordance with our PDPA Notice. Please refer to our website www.aimst.edu.my for further details. If you agree for your personal data to be collected and processed by us please tick ( √ ) in the box below. Agree  ✓ Disagree  ay - ____________________ Name: Cheah Wen Ye NRIC No. /Passport No.: ogoszs ol 0614 - - Date: 16/6/23 REV_1 (2022)  AIMST-SOP-07-01_FRM001 FOR OFFICE USE ONLY STUDENT RECRUITMENT DIVISION Documents Complete Documents Incomplete Counselled by, Specify: ……………………………………………………………………………………… ……………………………………… ……………………………………………………………………………………… Signature ……………………………………………………………………………………… Name: Date: ……………………………………………………………………………………… FINANCE AND ACCOUNTS DIVISION Application Fees Enclosed: Bankers Cheque / Bank Draft No………………. Cash : RM……………………………………….. Others : RM……………………………………….. ……………………………………… Signature Name: Date: STUDENT ADMISSIONS AND RECORDS DIVISION Documents Complete Documents required (please specify)…………………………………….. Checked by :……………………………….. Date:………………………….. …………………………………….. Rechecked by :……………………………….. Date:………………………….. Signature Verified by :……………………………….. Date:………………………….. Name: Date: SELECTION COMMITTEE/ DEAN Admission Status Affirm Offer Conditional Rejected Feedback to Applicant …………………………………….. …………………………………………………………………………… Signature …………………………………………………………………………… Name: Date: …………………………………………………………………………… …………………………………………………………………................ Please return this form to: STUDENT RECRUITMENT DIVISION AIMST UNIVERSITY Semeling, 08100 Bedong, Kedah Darul Aman, Malaysia. FOR MORE INFORMATION PLEASE CONTACT TEL: 604-429 8000 / 8199 Whatsapp: 012-5398108 E-MAIL: [email protected] WEBSITE: www.aimst.edu.my FACEBOOK: Aimst2U REV_1 (2022)