UNDERGRADUATE STUDIES ONLINE APPLICATION

ACADEMIC & IMMIGRATION RECORD

Please state whether you have previously
attended any Malaysia public or private
institution of higher learning

Status

Yes No

Name of institution

Name of programme

Enroll

From To e.g : 18/08/1988 (ddMMyyyy) Please Key In Date Followed By Example Please Key In Date Followed By Example

Student ID No

State

Reason for leaving previous Institution

Completed study Withdraw Terminated

Are you currently studying in any of the private or public institution of higher learning in Malaysia?

Status

Yes No

Name of institution

Name of programme

Enroll

Student ID No

State

If you are now in Malaysia, please specify your immigration pass type :

Dependent Diplomatic Social Visit Student

Expiry Date

e.g : 18/08/1988 (ddMMyyyy) Please Key In Date Followed By Example

Note : Conversion of an existing Social / Dependant / Diplomatic Pass to Student Pass or an existing Student Pass with another

institution to UTeM is strictly not allowed. Cancellation of the existing Pass and a fresh Student Pass application must be made

through UTeM if you are offered.