Please read carefully and answer with precision.

M alaysian [ ] International [ ] Country:

N ationality: Passport N o.: Valid till:

PART I: PERSON AL DETAILS

Title: M r [ ] M s [ ] M rs [ ] O ther

N ame (as per N RIC / passport):

N RIC N o: O ld: N ew:

Gender: M ale [ ] Female [ ] Date of birth : (dd/mm/yy)

Race: Religion: Place of birth:

M ailing Address:

Zip/Postcode: City/State :

Tel: Home: M obile: Email:

Parent/ G uardian

N ame: Relationship:

Tel: Home: M obile: Email:

O ccupation:

Contact person in case of emergency

N ame: Relationship with applicant:

Tel: Home: M obile: Email:

O ccupation:

Please complete and return this application form to:Advance Tertiary C ollege, 6th floor, Bangunan Tunas Utama, Jalan Petaling, 50000 Kuala LumpurTel: 1 800 88 9292 | 6 03 2031 0266 Fax: 6 03 2031 0261 Email: enquiries@atc2u.com

Race: Religion:

Income:

IC No:

Below - RM20,000 [ ] RM 50,000 - RM100,000 [ ]RM 20,000 - 50,000 [ ] RM 100,000 - Above [ ]

PART II: ACCOM M ODATION

Do you require ATC to arrange accommodation? Yes [ ] N o [ ]

PART III : COURSE DETAILS

Selected programme and specification as listed below:

M ode of Study Full Time [ ] Part Time [ ]

Intake Year: Intake month:

UN IVERSITY OF CAM BRIDG E A LEVEL

Economics [ ] Business Studies [ ] Accounting [ ] Law [ ]

M athematics [ ] English Literature [ ]

Please note that full time students must select a minimum of 3 subjects and part time students a minimum of 2 subjects. The choice ofsubjects is based on available combinations).

BUSIN ESS PROG RAM M ES

Cer t if ica t e in B usin ess St udies [ ]

Diplom a in M a n a g em en t [ ]

I C S A [ ]

[ ]

LAW PROG RAM M ES

UNIV ER SIT Y OF LONDON B A CH ELOR OF LAW S

YEAR O N E : IN TERM EDIATE [ ]

YEAR TWO : FIN AL PART I [ ]

O ptional subjects (Choose O ne) Evidence [ ] Commercial [ ] Family [ ]

YEAR THREE : FIN AL PART II [ ]

O ptional subjects (Choose 3) Evidence [ ] Commercial [ ] Family [ ]

Conflict of Laws [ ] Succession [ ] EU Law [ ]

Company [ ]Criminology [ ]Intellectual Property [ ]

Cer t if ica t e in Leg a l P r a ct ice [ ]

PART IV: ACADEM IC BACKG ROUN D

Please attach a copy of your certificates and the transcripts of all results obtained for your highest level of study currently including

SPM / O -Level / equivalent AN D STPM / A Level / equivalent plus a certified translation if the originals are not in English (except

M alaysian students)

Document attached

O Level / SPM / or equivalent [ ] Undergraduate Degree Cert & Transcript [ ]

A Level / STPM / or equivalent [ ] Diploma Cert & Transcript [ ] O thers [ ]

Diplom a in Market ing [ ]

Bachelor (Hons) in Management Studies

PART V: M EDICAL DISCLOSURE ( All students must complete)

Do you have any medical condition that requires the attention of the College? If yes, please indicate below:

Allergies [ ] Anaemia [ ] Asthma [ ] Colour Blindness [ ]

Epilepsy [ ] Heart disease [ ] Diabetes [ ] O thers [ ]

(Please give details)

Blood Type:

1. It is compulsory for all international students to purchase a Health Care Plan and keep it valid throughout the academic study

period at ATC.

2. Students from Yellow Fever Endemic Zones and other affected areas are required to have an International Health Certificate

showing Yellow Fever Vaccination as part of the submission for M alaysian Immigration purposes.

PART VI: CHECKLIST OF DOCUM EN TS

M alaysian Students International Students

[ ] Photocopy of N RIC [ ] Photocopy of all pages of passport

[ ] Photocopy of all academic certificates / transcripts [ ] Photocopy of all academic certificates / transcripts

[ ] Photocopy of trial / forecast results (where relevant) [ ] Photocopy of trial / forecast results (where relevant)

[ ] 4 passport sized photographs [ ] 4 passport sized photographs

[ ]

Banker’s Draft payable to MACRO SYSTEM CONSULTANCYSDN BHD for USD 1250 (non-refundable)

How was ATC introduced to you?

Friends [ ]

[ ]

Website [ ] Advertisments [ ] Teachers / Counsellors [ ] Parents / Guardians [ ]

O thers [ ]

PART VII: REQUIREM EN TS OF THE

The M inistry of Higher Education M alaysia requires that all students must enroll for the following subjects as part of their

pre-tertiary and tertiary education. If you have already completed any of the following subjects (after SPM / O Levels / equivalent)

please tick the appropriate boxes below.

Subject Completed

Bahasa Kebangsaan (A) (only M alaysian students withoutCredit for BM in SPM )

M alaysian Studies (All students)

Islamic Studies (O nly for M alaysian M uslim Students)

M oral Studies (O nly for M alaysian N on-M uslim Students)

Where you have complete any / all of the LAN subjects, please stipulate the following:

Year complete: Institution:

In order to be considered for exemption on the LAN compulsory subjects, please submit a copy of the LAN academic result together

with this application (not applicable to ATC students).

Facebook

Medical report[ ]

MPW 1113 |MPW 2113

MPW 1133 |MPW 2133

MPW 1143 |MPW 2143

MPW 1153 |MPW 2153

MALAYSIAN QUALIFICATIONS AGENCY (MQA)

PART VIII: PERSON AL STATEM EN T

Please explain in your own words your reasons for pursuing the course that you have selected with ATC.

PART IX : EN G LISH LAN G UAG E PROFICIEN CY (To be Completed by International Students O nly)

Have you taken any formal English Language test in the last 2 years: Yes [ ] N o [ ]

Test N ame: Test score:

Estimated English level:

PART X : IM M IG RATION IN FORM ATION (To be completed by International Students O nly)

Are you a current M alaysian Immigration Pass / Visa holder? Yes [ ] N o [ ]

Please specify type of Visa / Pass: Social [ ] Student [ ] Dependant [ ] Diplomatic [ ]

Date of expiry of current Visa / Pass: dd/mm/yy _______________

If you are transferring to us from another M alaysian institution / college / university, please provide the following documentation

from that institution / college / university:

Release letter [ ]

Results of most recent course of study [ ]

Attendance reports [ ]

O riginal O ffer / Acceptance Letter [ ]

If you are transferring to us from another M alaysian institution / college / university, please specify

duration studied there : _____ months ______ years

PART X I : TERM S & CON DITION S FOR EN ROLM EN T AT ATC

Applicable to ALL students

1. I understand that the Fees for the individual programmes are specified in the Fee Schedule.

2. I understand that payment of all relevant fees must be made BEFO RE the course commences and students may make

payment either by banker’s draft ( international students) or local cheques payable to M acro System C onsultancy Sdn.

Bhd.

3. I understand that enrolment for a course together with the payment of the required fees creates a binding Agreement to

follow the course and to pay the full fees in the prescribed manner.

4. I understand that I am required to wear my student card at all times while on the premises and failure to do so may result

in me being asked to leave the premises.

5. I undertake to abide by all academic, administrative and examination rules, regulations and policies currently in force or

as shall be changed from time to time by ATC .

6. I understand that ATC reserves the right to use student personal information to carry out its responsibilities in the personal

and academic interest of the student. The scope of usage of this information may include publication of student’s photo,

examination results, prize awards, scholarship awards and other information relevant to the student’s education at ATC .

7. I understand that ATC reserves the right to require a student to leave the course at any stage if the student’s continued

presence would, in the opinion of the M anagement of ATC , be detrimental to the satisfactory running of the course. Any

fee refund and the amount to be refunded to such an excluded student is wholly at the discretion of the M anagement of

ATC .

8. I understand that smoking on ATC premises or in the immediate vicinity of the premises may result in my immediate

expulsion from the institution.

9. The M anagement of ATC reserves the right to cancel a course provided two weeks’ prior notice (one week for a revision

course) is given. Any fees paid to the college in such an instance will be refunded in full.

10. The M anagement of ATC will assume no responsibility for any loss, damage, death or injury occasioned to any student not

arising out of the negligence of the institution.

11. It is a condition of this Agreement that all students enrolled at ATC must indicate in all UN IVERSITY O F LO N DO N &

UN IVERSITY O F C AM BRIDG E documentation that they are students of ATC .

12. It is a further condition of this Agreement that the onus is on all students enrolled on any course at ATC to ensure that

the satisfy all the eligibility requirements for the said course and / or for any further course(s) that they may wish to pursue.

13. Where a student is applying for a loan / scholarship from any institution, ATC shall provide the student with a letter

stipulating the amount of fees payable for the programme. This letter may only be released to a student who has paid the

Registration Fees and has become a student of ATC .

14. Please note that in all circumstances, the Registration Fee is non-refundable. Should a student discontinue the programme

for any reason, the determination of the refund of fees shall be on a case-to-case basis. The decision of the M anagement

of ATC on this matter is final.

15. I have read and understood ATC ’s refund policy stated in the Fee G uide and shall adhere to it.

16. I understand that all course fees (where applicable) must be paid by the 7th of every month. I understand that a late

payment fine of RM 20-00 will be charged where the fee is paid after the 7th of every month. I understand that where my

fees remain unpaid for 21 days from the due date ATC can exercise its discretion to deny me the use of the facilities and

prevent me from attending classes until the fees are paid.

I hereby acknowledge that i have read & understood the terms and conditions above and I accept all the responsibilitiesand requirements that are imposed on me.

Signature Date

enquire

STATEM EN T OF CON DITION AL ACCEPTAN CE : A’ LEVEL ( UN IVERSITY OF CAM BRIDG E IN TERN ATION AL EX AM IN ATION S)

I, ____________________________________________ N RIC / Passport N o ________________ affirm that

I am fully aware that general entry / eligibility requirements for the A’ level programme is minimum of 5 C ’s in SPM / O ’ Level or

equivalent. I am aware that my acceptance at ATC is conditional upon me satisfying the above requirements.

STATEM EN T OF CON DITION AL ACCEPTAN CE : UN IVERSITY OF LON DON BACHELOR OF LAW S

( Applicable to ALL students enrolling on the University of London Bachelor of Laws programme)

(Please fill in the relevant information)

I am aware that the general entry / eligibility requirements for the University of London Bachelor of Laws (LL.B) programme are :

(a) 3 SPM / O Level credits or equivalent ( including English and Bahasa Malaysia obtained in a single sitting );

(b) 2 STP M ( Min CGPA 2.00 ) / A Level Principle Passes or its equivalent in a single sitting );

I, ____________________________________________ N RIC / Passport N o ________________ affirm that

I am fully aware of the requirements and that I have / do not have the requisite requirements. I have obtained / will obtain the

necessary entry requirements before sitting for the Intermediate examinations of the University of London LL.B programme.

I am aware that my acceptance at ATC is conditional upon me satisfying the above requirements.

STATEM EN T OF CON DITION AL ACCEPTAN CE : CERTIFICATE IN LEG AL PRACTICE

( Applicable to ALL students enrolling on the University of London Bachelor of Laws programme who are intending to do the

Certificate in Legal Practice)

(Please fill in the relevant information)

I am aware that the general entry / eligibility requirements for the Certificate in Legal Practice programme are :

(a) 3 SPM / O Level credits obtained in a sitting; AN D

(b)

I, _______________________________________, N RIC N o : ________________ affirm that I am fully aware of the requirements and

that I have the requisite requirements. I intend to read for the Certificate in Legal Practice and

APPLICABLE TO IN TERN ATION AL STUDEN TS ON LY

17. I understand that as an international student, I will be required to pay the Immigration and Administration Fees in advance in

order for the institution to process the Student Visa with the M alaysian Immigration Department. In instances where I opt to

withdraw from the programme (for whatever reason) these fee payments are non-refundable.

18. I am aware that I will be required to pay the remaining fees before the release of the Student Visa to me.

I declare that the statements made by me and all the information provided herein are correct to the best of my knowledge and I

hereby agree to be bound by the terms and conditions stated above which I have read and understood.

_________________________________ _________________________Student’s Signature Date

_________________________________Parent’s Signature / N ame(Applicable for students under 18 years of age)

(c) Degree in Laws recognised by the LPQB Malaysia

will ensure that all therequirement will be met

2 STP M ( Min CGPA 2.00 ) / A Level Principle Passes or its equivalent in a single sitting );