KOLEJ ASA ODL REGISTRATION FORM
REGISTRATION FORM YEAR 2023
DATE
-
Day
-
Month
Year
Date
COUNSELOR
State the name or company
STUDENT E-MAIL
*
example@example.com
INTAKE
*
Please select
APRIL/ MAY 2023
AUGUST/SEPTEMBER 2023
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PERSONAL DETAILS
FULL NAME (AS IN IC/PASSPORT)
*
NRIC NO.
*
RACE
*
Please Select
MALAY
CHINESE
INDIAN
NON-MALAY BUMIPUTERA
OTHERS
COMPLETE ADDRESS WITH POSTCODE
*
CONTACT NO.
*
GUARDIAN FULL NAME
*
GUARDIAN CONTACT NO.
*
RELATIONSHIP WITH GUARDIAN
*
Please Select
FATHER
MOTHER
STEP PARENT
UNCLE
AUNT
GRANDFATHER
GRANDMOTHER
SISTER
BROTHER
LEGAL GUARDIAN
HUSBAND
WIFE
SPM / STPM/ O LEVEL/ SKM / CERTIFICATE / DIPLOMA & TRANSCRIPT & EQUIVALENT
*
Browse Files
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of
NRIC COPY (FRONT & BACK IMAGE)
*
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of
PASSPORT PHOTO (USED FOR STUDENT ID CARD)
*
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accepted document- jpg, jpeg, png, jfif
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of
HOUSEHOLD INCOME - MONTH
*
Please Select
B1 - < RM2,500
B2 - RM2,501 - RM3,169
B3 - RM3,170 - RM3,969
B4 - RM3,970 - RM4,849
M1 - RM4,850 - RM5,879
M2 - RM5,880 - RM7,099
M3 - RM7,110 - RM8,699
M4 - RM8,700 - RM10,959
T1 - RM10,961 - RM15,039
T2 - >RM15,040
COURSE APPLIED
*
Please Select
DIPLOMA IN ACCOUNTING (ODIA)
DIPLOMA IN MANAGEMENT (ODIM)
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STUDENT DECLARATION
I, hereby acknowledge all information provided in this form is accurate and true. If there are any changes, I will make the necessary arrangements to inform Kolej Asa Administrative Office.
*
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