Full Time Courses Enrolment Form

FULL TIME OR PART-TIME

KCC ON-LINE ENROLMENT FORM

FULL-TIME COURSES (Kursus-Kursus Penuh Masa)

COURSE(S) TITLE (NAMA KURSUS) :

Full-Time

Name : (PLEASE USE BLOCK LETTERS)
(Nama) (GUNAKAN HURUF BESAR)

Date of Birth (Tarikh Dilahirkan) :

Place of Birth (Tarikh Dilahirkan):

I . C. No. (No. Kad Pengenalan) :

Sex (Jantina) :

Male (Lelaki)

Female (Perempuan)

Nationality (Warganegara) :

Race (Bangsa) :

Religion (Ugama) :

E-mail Address (Alamat E-mail) :

Postal Address :
(Alamat Surat Menyurat)

Tel No. (No. Telefon) :

Hse (Rumah)

H/P (Bimbit)

Last School Attended :
(Sekolah Terakhir Yang Dihadiri)

Latest Examination :
(Peperiksaan Yang Terakhir)

Results (Keputusan) :

Year (Tahun) :

Name of Parent / Guardian :
(Nama Ibu-Bapa / Penjaga)

Relationship of Guardian :
(Hubungan Penjaga)

Parent / Guardian Occupation : (Perkerjaan Ibu-Bapa / Penjaga)

Postal Address :
(Alamat Surat Menyurat)

Tel No. of Parent / Guardian :
(No. Telefon Ibu-Bapa / Penjaga))

Have You Study in KCC before?
(Anda Benar Belajar di KCC?)

Yes (Ya)

No (Tidak)

What Course ?

Which Year ?

How Did You Hear of this Course?
(Bagaimana Anda Tahu Akan Kursus Ini?)