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KLMUC - Online Enquiry Form
  Online Registration Form      
                         
 
PERSONAL DETAILS
 
Fields marked with * are mandatory.
Mr
Mrs
Miss
Name*
Email*
IC/Passport*
Example:- 920521045026
Sex
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Female
Date of Birth
Example:- 21-05-1992
Nationality
Contact Address*
City
State  
Postcode  
Tel No*
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Mobile  
-
Fax
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Highest Academic Qualification
Phd
MSc
Degree
Diploma/Advance
STPM / O Level
SPM / A Level
Others
 
 
PARENT / GUARDIAN DETAILS
Name of Father/Guardian
 Relationship
Address
City
State
Postcode
Tel No
H/P No
Fax No
 
 
Education Advisor Name / ID (Optional) : 
 
 
Signature *  (Please insert your name)
Date
 
 
 
Note : Please only check appropriate and applicable boxes
 
                         


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STUDENT SERVICES
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PROSPECTIVE STUDENTS
- Alumni
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- Ungku Aziz Resource Library
 
 
FORMS / OTHERS
- Feedback Form
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- Teaching Slide Template (KLMUC Lecturer)
- Teaching Slide Template (Cosmopoint Lecturer)
 
CAREER
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1-800-88-5568
For Tour to Our CAMPUS & Further
Enquiry on your Education &
Career Pathway
 
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