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PHOTO 照片

please upload passport size photo
请上传个人大头照

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PERSONAL INFORMATION 个人资料
Name of Applicant 姓名
Date of Birth 出生日期

日期月年
日期
NRIC/Passport No 身份证号码
Gender 性别
Nationality 国籍
Marital Status 婚姻状况
Address 地址
Highest Qualification 最高学历
Email Address 电邮
example@example.com
Tel 电话号码

郵遞區號電話號碼
Facebook Id 面子书账号
PROGRAMME PREFERENCE
Course Name
Duration : 3 months to 6 months on job training
DETAILS OF FAMILY MEMBERS 家庭成员资料
Father's Name 父亲姓名名字 Address 地址 Street Address Address Line 2 城市 State Zip Mobile Number 电话号码電話號碼
Mother's Name 母亲姓名名字 Address 地址 Street Address Address Line 2 城市 State Zip Mobile Number 电话電話號碼
IC upload 上传身份证

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Highest Qualification (Certificate Of Highest Qualification) 最高资格（最高资格证书）

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EDUCATION BACKGROUND 教育背景
WORKING EXPERIENCES 工作经验
I, understood that this is not an academic MQA program and it cannot use to further study to MQA program. 我明白这不是一个学术MQA程序，它不能用于进一步学习MQA程序。
Signature of Applicant 申请者签名

Clear
Name of Applicant 申请者名字
Date 日期

日期月年
日期
Bank In Detail 银行资料：

Alliance Bank

Caredemy Training Sdn Bhd

Account Number：1402-800-1300-6529
Amount that you paid 付款价格RM
Bank In Slip 单据

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Please click the course that you choose:
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Professional Diploma Certificate In Postnatal Care TherapyRegistration fees + Material Fees + Tuition Fees
15,088.00MYR



Professional Diploma Certificate In Pre & Postnatal Massage TherapeuticRegistration Fees + Material fees + Tuition Fees
12,088.00MYR



ManagementProfessional Diploma Certificate In Elderly Care ManagementRegistration Fees+ Material Fees + Tuition Fees
12,088.00MYR



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0.00MYR
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REGISTRATION FORM

powered by

PHOTO 照片

PERSONAL INFORMATION 个人资料

PROGRAMME PREFERENCE

Duration : 3 months to 6 months on job training

DETAILS OF FAMILY MEMBERS 家庭成员资料

EDUCATION BACKGROUND 教育背景

WORKING EXPERIENCES 工作经验