Student Registration Form

Basic Information

Name (as per NRIC/Passport)*

NRIC / Passport Number*

Date of Birth*

Day

Month

Year

Age*

Email*

Phone*

Country of Citizenship*

Gender*

Male

Female

Other

Current Education Level?*

High School Student (18 years old and above)

Pre-U/Diploma Student

Undergraduate Student

Postgraduate Student

Other

Contact

0162239225

0172878295

Quick Links

Address

Bukit Jalil,

58200 KL WP,

Kuala Lumpur

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