Salutation Mr Ms Mrs Dr.

Name

Nationality

DOB

Gender Male Female

Mobile Number

Email

Highest Qualification

Offer letter from University Yes No

If Yes, Institute / University

Level PhD Master Degree Foundation Certificate Skill Based

Course

If No, Institute / University of interest

Course of interest

Duration of study

Annual course fees (RM)

Example: 10000.00

Total course fees (RM)

Example: 10000.00

Loan amount to apply (RM)

Example: 10000.00

Co-Applicant Name

Relationship Father Mother Sibling Others

Others

Occupation

Monthly gross income (RM)

Example: 10000.00

.

Security question : 5 * 5 is

Enter the verification code

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