Scribd
Upload
83 views1 page

JMTI Application Form

This document is an application form for admission to the Technical Institute of Japan Malaysia (JMTI). It requests personal information from applicants such as name, identity card number, citizenship, gender, marital status, address, contact numbers, academic qualifications, and emergency contact. Applicants must attach recent passport photos, photocopies of their identity card and academic certificates, and pay a registration fee. By signing the form, applicants confirm that the information provided is true and acknowledge that the program is not accredited and fees will not be refunded if they withdraw.

Uploaded by

Samuel Lau 刘恩得
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
83 views1 page

JMTI Application Form

This document is an application form for admission to the Technical Institute of Japan Malaysia (JMTI). It requests personal information from applicants such as name, identity card number, citizenship, gender, marital status, address, contact numbers, academic qualifications, and emergency contact. Applicants must attach recent passport photos, photocopies of their identity card and academic certificates, and pay a registration fee. By signing the form, applicants confirm that the information provided is true and acknowledge that the program is not accredited and fees will not be refunded if they withdraw.

Uploaded by

Samuel Lau 刘恩得
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 1

INSTITUT TEKNIKAL JEPUN MALAYSIA (JMTI)

Plot 59, Lorong Perindustrian Bukit Minyak 15


Taman Perindustrial Bukit Minyak,
14100 Simpang Ampat, Seberang Perai Tengah, Pulau Pinang.
Tel : 04 508 7800 Faks : 04 508 7809
______________________________________________________________________________________
PERMOHONAN KEMASUKAN PROGRAM / APPLICATION FORM

PILIHAN PROGRAM / PROGRAM APPLIED FOR

MAKLUMAT PEMOHON / PERSONAL INFORMATION

NAMA / NAME : ________________________________________________________________________________________

NO. KAD PENGENALAN / IDENTITY CARD NO : ___________________________________________________________


Please attach an official
WARGANEGARA / CITIZENSHIP : ________________________________________________________________________
passport sized recent
photograph
JANTINA / GENDER : ____________________________________________________________________________________
of yourself here plus an
extra copy with your
TARAF PERKAHWINAN / MARITAL STATUS : _____________________________________________________________
name written at the back

ALAMAT / ADDRESS : ___________________________________________________________________________________

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

NO TELEFON / TELEPHONE NO : (H/P) ______________________________ (HOUSE/OFFICE) ___________________________

KELAYAKAN AKADEMIK / ACADEMIC QUALIFICATIONS : ________________________________________________________

NAMA YANG BOLEH DIHUBUNGI, JIKA BERLAKU KECEMASAN / CONTACT PERSON IN CASE OR EMERGENCY :

_____________________________________________ NO TELEFON / TELEPHONE NO : (H/P) __________________________

PENGAKUAN PEMOHON / APPLICANT’S CONFIRMATION : Saya mengaku bahawa keterangan yang diberikan di atas adalah
benar dan faham bahawa program ini tidak mendapat pengiktirafan MQA serta tidak akan menuntut pemulangan yuran
sekiranya menarik diri daripada program / I certify that the information given above is true and understand that this
program is not accredited by MQA and will not claim refund of fees if withdraw from the program.

_______________________________ _________________
TANDATANGAN / SIGNATURE TARIKH / DATE
_______________________________________________________________________________________________________

CHECKLIST FOR SUBMISSION


1. Official passport sized recent photograph – 2pcs 2. Photocopy of identity card – 2 sets (A4 paper format)
3. Photocopy of academic certificates – 2 sets 4. Photocopy of employment letter - 2sets
5. Registration Fees

You might also like