Student Name:

Malaysian Undergraduate Application Form

Instructions:
1. Please fill out this form clearly in pen.
2. Enclose all supporting documentation with this application. (All documents must be certified by a recognised authority).
This application will not be processed unless full documentation is attached.
3. An application fee of RM100 (non-refundable) is payable on submission of this form. Bank draft is to be made payable to
“MONASH UNIVERSITY SUNWAY CAMPUS (M) SDN BHD. Cash is only payable at the Financial Services Cashier Counter.
4. This application is the property of Monash University. Supporting documentation will NOT be returned.
5. It is your responsibility to advise Monash University Sunway campus regarding any change of address.
6. Send your application to: Prospective Students Office
Monash University Sunway campus,
Jalan Lagoon Selatan, Bandar Sunway
46150 Petaling Jaya
Selangor Darul Ehsan, Malaysia
Telephone +603 5514 6000
Email [email protected]
Website www.monash.edu.my

Office use only

Finance Marketing Prospective Students Office

Tracking No: ID No: Course code:

Section A: Your application

1. Have you previously applied to Monash University? Yes No
If yes, please state your Monash ID No:

2. Are you currently applying to/studying at another Monash campus? Yes No

If yes, please state your Monash ID No:

3. Have you changed your name since you last applied to /studied at Monash University? Yes No
If yes, please provide / attach relevant documentation.

4. Are you applying for Scholarship/Sponsorship? Yes No

If yes, which organisation? Please indicate:

5. This application is submitted by:

You (direct application).
A Monash registered agent on your behalf. Name of Monash representative / agent:
The organisation sponsoring you. Name of sponsor:

www.monash.edu.my
 Section B: Personal details (Please state name as per NRIC)
We may contact you by email, post or telephone. To avoid delays in your application, it is important you complete ALL your details
including your email address.

Title: (eg. Mr, Ms, Mdm) Family name/Surname:

Given name/s:
NRIC number: Sex M F
*Note: Please refer to the University age requirements for admissions at
Date of Birth* www.monash.edu.my/advancement/future/

Nationality Country of Birth

*Religion Muslim Buddhist Hindu Christian Other. Please specify:
* For government reporting only.

Postal address for correspondence (or agent’s address where applicable)

State/Region Postcode
Phone (Home) Phone (Office)
Mobile number Fax
Email address

Home address (essential)

State/Region Postcode
Country Fax
Phone (Home) Phone (Office) Mobile number
Email address

Section C: Course preferences

Choose 3 courses you would like to study and list them in order of preference

Course title Commencing semester and year

(month/year eg. Feb 2009, July 2009)

1.
2.
3.
Note: Monash University reserves all rights in offering the courses available and their commencing semester

Section D: English language proficiency

All courses have English language proficiency requirements. You must provide proof of your English proficiency to the required standard.

English was the language of instruction in previous studies completed (must attach certified evidence, this may not satisfy the
English requirements for some courses)
I will sit/have sat for an English language proficiency test IELTS TOEFL
Date taken/sitting:

If you do not meet the course English requirements, you may be eligible for an English Language Bridging Program (ELBP).
If so, Monash will advise you with a conditional offer.
Please consider my application for ELBP if I am eligible.

Malaysian Undergraduate Application Form

Section E: Academic qualifications and other required documents
Certified copies of academic qualifications must be attached to this application. If the qualifications are in languages other than English,
please also supply certified translated copies. The documents must be certified by your current or previous education institution; a
Monash registered representative or agent; a Monash staff; a solicitor; or commissioner for declarations. Monash University Sunway
campus reserves the right to refuse documentation on the grounds of incorrect certification or translation procedures.

Secondary studies
Part 1: SPM/O-Levels/Year 11 or equivalent - Please provide a certified copy of academic transcripts/ results
Year obtained: State / Country:
Assessment / qualification type eg. SPM/O-Levels:
Name of school/institution:

Part 2: STPM/A-Levels /Year 12 or equivalent eg. Pre-U – Please provide a certified copy of academic transcripts/ results
Year obtained: Score / Result:
State / Country: Name of institution:
Assessment /qualification type eg. STPM/A-Levels/CIMP/MUFY/etc:
Are you currently awaiting results of any secondary or Pre-U studies? Yes No
If yes. Name of qualification and institution:

Date on which the results will be available:

Tertiary studies
Please submit a certified copy of academic transcripts /results for ALL qualifications/academic studies, either currently enrolled,
completed or discontinued, including failures (if any). Please use additional pages if space below is insufficient.
Degree / qualification:
Field of study/ Major/ Specialisation: Institution:
Year commenced (MM/YY): Year last attended (MM/YY):
State/Country: Did you complete? Yes No
Are you currently awaiting results of any post secondary or professional or tertiary studies? Yes No
If yes. Name of qualification and institution:

Date on which the results will be available:

Please state what activities you have engaged in since your last academic studies to the present date (if the gap/period is six
months or more):

Section F: Employment history

Please provide details of any employment experience that may be relevant to the course application.
Supporting documentation ie. CV or references may be submitted. Please use additional pages if space below is insufficient.

Occupation / Position:

Start date: End date:

Employment type: FT PT Employer name:

Position and duties:

Section G: Credit transfer

If you request a credit transfer, please fill up the “Application for Credit Transfer” form and include relevant information on your previous or
current course (eg. Syllabus/curriculum). Further information may be requested if your previous course/institution has not been previously
assessed by Monash University.

Do you wish to apply for credit transfer from previous study? Yes No
(For additional information visit: http://www.monash.edu.my/advancement/future)

Malaysian Undergraduate Application Form

 Section H: Important checklist

Application form filled out in full and signed?

Application fee of RM100
A copy of Malaysian identification card

One certified copy of Secondary Education (SPM/O-levels or equivalent)

One certified copy of Secondary Education (Pre-U, A-levels, CIMP, MUFY or equivalent)
One certified copy of Tertiary Education (if applicable)
Proof of English proficiency (if applicable)

Signed credit transfer application (if available)

Subject syllabus(es) or/and brochure or prospectus of institution (if applicable)

Section I: Declaration
I warrant that the information on this form, or provided in support of my application, is correct and complete. I acknowledge that the provision
of incorrect information or the withholding of relevant information relating to my application, including academic transcript/s, might invalidate
my application and that the University may withdraw an offer of a place or cancel my enrolment in consequence.
Should the University determine that I have submitted a false document, I consent to the University disclosing this information to other
relevant tertiary institutions.
I consent to any educational institution at which I have previosuly been a student and/or my current or any past employer, providing Monash
University with information which that institution or employer holds about me for the purpose of Monash University verifying my grades and/or
qualifications and experience.
I accept that information provided by me will be retained by Monash University Sunway campus, and will be made available to Monash
University and the federal state government agencies, pursuant to obligations under the Private Higher Education Act 1996 (Act 555).
I agree to abide by the statutes, regulations and policies of Monash University.
I have read and understood the above conditions and accept them fully.

Date
Applicant’s signature

Office use only

Offer of Admission
Additional comments (if any): Rejection – No offer

Reason for rejection – tick appropriate box

insufficient quota
documentation unsatisfactory
Offer Authorised by: not qualified
Date:
Rejection Authorised by:
Offer of Admission with conditions Date:
Offer Conditions – please state:

Reconsideration Requested
Outcome:

Conditional Offer Authorised by:

KP(JPS)/5195/US/595(16) KP/JPS/DFT/US/B04 Printed October 2008

Date:

Offer Conditions Met Yes No Authorised by:

Authorised by: Date:
Date:

Remarks:

Malaysian Undergraduate Application Form