New Application Form (Updated 2017) · ã x v w } ð W Zd W WZK'Z DD t KDW d E z KhZ^ ^ W o ] l ~ O...

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S/NO: PLP/KCH/2017 1 PUSAT LATIHAN PROAKTIFISO 9001: 2008 Lot 2331-2335, Jalan Simen Raya, Pending Industrial Estate, Pending Industrial Estate, 93450 Kuching, Sarawak Tel: 082-480868 Fax: 082-330464 Website: www.plproaktif.edu.my COURSE APPLICATION FORM USE CAPITAL LETTERS / GUNAKAN HURUF BESAR * Mandatory to be fill / Wajib diisi PART A: PERSONAL DETAILS / Butir-Butir Peribadi * Full Name (as per IC) / Nama Penuh (mengikut KP) * I.C. No. / No. K.P. * Nationality / Warganegara * Date of birth / Tarikh Lahir * Race / Bangsa * Status: * Gender/Jantina: Married /Berkahwin Single /Bujang Male / Lelaki Female/Perempuan * Home Address / Alamat Rumah: Postcode : * Home Phone Number / Telefon Rumah: * Office Telephone Number / Telefon Pejabat: - - * H/P Number / Telefon Bimbit: Fax Number / Nombor Faks: - - * E-mail: _______________________________________ * EDUCATION BACKGROUND / Latar Belakang Pendidikan Name of School / College / University Nama Sekolah / Kolej / Universiti Qualification Kelayakan Year Tahun Please glue one passport sized photo here / Lekat satu gambar bersaiz passport di sini

Transcript of New Application Form (Updated 2017) · ã x v w } ð W Zd W WZK'Z DD t KDW d E z KhZ^ ^ W o ] l ~ O...

Page 1: New Application Form (Updated 2017) · ã x v w } ð W Zd W WZK'Z DD t KDW d E z KhZ^ ^ W o ] l ~ O Z } ] } Æ l^ ] o v l v ~ O o u l } l Ç v P l v v

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PUSAT LATIHAN PROAKTIFISO 9001: 2008

Lot 2331-2335, Jalan Simen Raya, Pending Industrial Estate, Pending Industrial Estate, 93450 Kuching, Sarawak Tel: 082-480868 Fax: 082-330464 Website: www.plproaktif.edu.my

COURSE APPLICATION FORM USE CAPITAL LETTERS / GUNAKAN HURUF BESAR * Mandatory to be fill / Wajib diisi

PART A: PERSONAL DETAILS / Butir-Butir Peribadi

* Full Name (as per IC) / Nama Penuh (mengikut KP)

* I.C. No. / No. K.P. * Nationality / Warganegara

* Date of birth / Tarikh Lahir * Race / Bangsa

* Status: * Gender/Jantina: Married /Berkahwin Single /Bujang Male / Lelaki Female/Perempuan

* Home Address / Alamat Rumah:

Postcode :

* Home Phone Number / Telefon Rumah: * Office Telephone Number / Telefon Pejabat:

- -

* H/P Number / Telefon Bimbit: Fax Number / Nombor Faks:

- -

* E-mail: _______________________________________

* EDUCATION BACKGROUND / Latar Belakang Pendidikan

Name of School / College / University Nama Sekolah / Kolej / Universiti

Qualification Kelayakan

Year Tahun

Please glue one passport sized photo here /

Lekat satu gambar bersaiz passport di sini

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* Working Experience / Latar Belakang Pekerjaan

Job’s Title / Position Jawatan Dipegang

Name of Organisation Nama Organisasi

Period (Months / Years) Tempoh (Bulan / Tahun)

* PROFICIENCY IN LANGUAGES / Kecekapan Bahasa

Please tick (√) the appropriate box / Sila tandakan (√) dalam kotak yang berkenaan LANGUAGES PROFICIENCY EXCELLENT GOOD FAIR WEAK

English Written

English Oral

Bahasa Malaysia Written

Bahasa Malaysia Oral

Others: _________________ Written

Others: _________________ Oral

PART B: PARENTS / GUARDIAN’S / SPOUSE’S INFORMATION

* PARENTS / GUARDIAN’S NAME / NAMA IBU / BAPA / PENJAGA / SPOUSE

* Contact No (H/P) / No Telefon (H/P) * Contact No Home/Office/No Tel Rumah/Pejabat

- -

* Mailing Address / Alamat Surat Menyurat:

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DECLARATION AND SIGNATURE / Pengesahan Dan Tandatangan

I declare that the information provided by me in this application is true and correct. I acknowledge that Pusat Latihan Proaktif reserves the right to vary or reserves any decision regarding admission or enrolment made on the basis of incorrect or incomplete information. I also accept the terms and condition

Saya mengesahkan bahawa semua maklumat dalam pemohonan ini adalah sahih dan benar. Saya bersetuju bahawa Pusat Latihan Proaktif berhak untuk mengubah keputusan berkenaan kemasukan sekiranya maklumat yang saya berikan adalah tidak benar atau tidak lengkap.

………………………………………………….. …………………………………………….. Signature of Applicant Date Tandatangan Pemohon Tarikh

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PART C: PROGRAMME – COMPETENCY COURSES Please tick (√) the appropriate box/Sila tandakan (√) dalam kotak yang berkenaan

PART D: TERMS AND CONDITIONS

1. Application form must be properly completed and attached with the relevant documents as stated in our application form. Photograph of the applicant must be attached to the application form.

2. RM 20.00 Enrollment Fee to be enclosed together with the application form submission. This fee is non-transferable and non-refundable.

3. 50 per cent on Course Fee together with a registration fee of RM 100.00 to be paid upon receipt of the Letter of Acceptance from Pusat Latihan Proaktif.

4. The Letter of Acceptance from Pusat Latihan Proaktif will be sent or given out to the student before the commencement of the class or on the first day of class.

5. The remaining final balance of your Course Fee must be paid prior to the commencement of the Course practical class; failing which the Management of Pusat Latihan Proaktif reserves the right to disallow the continuation of the student’s class.

6. Course Fee is non-transferable and non-refundable.

7. Students must adhere strictly to the Rules and Regulations of the Training Centre. No stealing and photographing are allowed during and around the training premises. Anyone caught will be penalized accordingly.

8. The Management of Pusat Latihan Proaktif reserves the right to withdraw any application should be information given is found to be false.

a) WIREMAN GRADE 2

b) WIREMAN GRADE 1

c) CHARGEMAN L-1 (415 V SYSTEM)

d) CHARGEMAN L-2 (OVER HEAD-LINES-LV)

e) CHARGEMAN L-3 (GEN-SET SYNCRONISING)

f) CHARGEMAN H1 (HIGH VOLTAGE)

g) CHARGEMAN L-4 (PV STANDALONE SYSTEMS)

h) ELECTRICAL INSTALLATION CONTRACTOR (EIC)

i) EIC-ATT (AUTHORIZED TO TEST)

j) SF6 GAS MAINTENANCE & SERVICING

k) LOW VOLTAGE DISTRIBUTION & SWITCHING

l) FIRST AID COURSE

m) CAMBRIDGE ENGLISH LANGUAGE COURSE (BULATS)

n) INNOVATIVE HIGH-END WOOD CRAFTMAN - SKILL LEVEL

o) INNOVATIVE HIGH-END WOOD CRAFTMAN - PROFESSIONAL LEVEL

p) DIGITAL LASER ENGRAVING AND CUTTING COURSE q) INDUSTRIAL DIGITAL 3D CNC DESIGNING & PROGRAMMING - CADCAM

r) INDUSTRIAL DIGITAL 3D CNC PRINTER

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PART E: APPLICATION CHECKLIST / Senarai Semak Permohonan

PART F: PAYMENT METHOD

No. ITEM Check /

Semak (√)

1 All sections of the form must be completed and the declaration signed and dated. Semua bahagian borang mesti diisi dan deklarasi ditandatangani. √

2 Enclose one certified copy of I.C. and all academic certificates and transcripts. Kepilkan satu salinan kad pengenalan dan sijil akademik dan transkrip yang disahkan. √

3 Enclose a copy of your resume. Kepilkan satu salinan resume. √

4 Attach ONE (1) passport sized photo Kepilkan SATU (1) gambar bersaiz passport. √

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Send complete application to: Hantar permohonan yang lengkap kepada: PUSAT LATIHAN PROAKTIF LOT 2331-2335, JALAN SIMEN RAYA PENDING INDUSTRIAL ESTATE 93450 KUCHING, SARAWAK TEL: 082-480868 FAX: 082-330464 Website: www.plproaktif.edu.my

√

1. CASH

2. CHEQUE (Please issue under Proaktif Electrical Sdn Bhd (Acct No. RHB 2111 460 001 4657)

3. ATM Transfer / Internet Banking

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PART G: CHECK LIST FOR SCHOLARSHIP’S APPLICATION / Senarai Semak Permohonan Biasiswa Kindly attach herewith the required supporting documents: Sila kepilkan bersama dokumen sokongan:

Student (Pelajar)

(a) 1 photocopy of IC (Salinan Kad Pengenalan)

(b) 2 passport size photo (2 keping gambar berukuran passport)

(c) Birth certificate (Sijil lahir)

(d) SPM and SRP certificate, PMR, STPM, Diploma or Degree certificate (Salinan sijil SRP, SPM, Diploma ataupun Sarjana)

(e) School relevant certificates (Aktiviti Ko-kurikulum - kegiatan sukan, persatuan/kelab sekolah/pasukan pakaian seragam dan sebagainya)

(f) School leaving certificate (Sijil berhenti sekolah)

Parents / Guardian (Ibubapa / Penjaga)

(a) Parents / Guardian photocopy IC – 1 each (Salinan kad pengenalan ibubapa / penjaga)

(b) A copy of 1 month (recent) pay slip (Salinan penyata gaji sebulan yang terkini samada daripada ibubapa / penjaga yang bekerja)

(c) If no source of regular income, please submit a letter from the Ketua Kampung / Penghulu as evidence (Jika tiada surat punca pendapatan tetap, sila kemukakan surat pengesahan dari Ketua Kampung / Penghulu sebagai bukti)


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