Borang Kad Pelaja Ruda
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This document is a student card application form that needs to be filled out completely based on an offer letter. It requests information such as the applicant's name, IC/passport number, matric number, mobile number, program, faculty, intake session, and whether any program changes were previously made. The applicant must sign and date the form to declare that all information provided is true and complete.
Borang Kad Pelaja Ruda
- 1. B/HEA/URA/207 1. Borang ini hendaklah diisi dengan lengkap berdasarkan surat tawaran. (Fill up the form completely based on offer letter) 2. Sila sertakan 1 keping gambar berukuran passport. (To attached 1 photo passport size) TARAF PENCALONAN ( Candidature ) : SEPENUH MASA ( Full-Time ) SEPARUH MASA ( Part-Time ) k NAMA ( Name ) k NO. K/P / PASPORT ( I/C No. / Passport No. ) k NO. MATRIK ( Matric No. ) k NO. TELEFON BIMBIT ( Mobile Phone No. ) k PROGRAM ( Programme ) FAKULTI ( Faculty ) SESI KEMASUKAN ( Intake Session ) ADAKAH ANDA PERNAH MEMBUAT PERTUKARAN PROGRAM? ( Have you made any program changes? ) YA (Yes) TIDAK (No) Dengan ini disahkan bahawa butir- butir peribadi dan maklumat yang diisi adalah benar dan lengkap ( I hereby declare that all information stated in this form is true and complete ) UNTUK KEGUNAAN PEJABAT ICT. TANDATANGAN PEMOHON (Applicant Signature) ____________________ TARIKH (Date) : ____/____/____ UNIVERSITI INDUSTRI SELANGOR No. Pendaftaran : KP / JPS / DFT / US / B06 No. Siri : PICT/0000 BORANG PERMOHONAN KAD PELAJAR ( STUDENT CARD APPLICATION FORM ) MAKLUMAT PERIBADI (PERSONAL PARTICULARS) Gambar (Photo) Catatan : 18