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HIGHLANDS INTERNATIONALCAMBRIDGE ‘A’ LEVELS

10 KM, Genting Highlands, 69000 Genting Highlands,Pahang Darul Makmur, Malaysia.

Tel: 03-6100 1688 Fax: 03-6100 3688 E-mail: truealevels@gmail.com

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STUDENT APPLICATION FORM

SECTION A : COMBINATION OF SUBJECTS / CHOOSE MINIMUM 3 AND MAXIMUM OF 4 SUBJECTS

Applicants must meet the entry requirement for Cambridge A’ level program prior to the submission of this form based on SPM

forecast result, or equivalent. Please complete all sections in BLOCK LETTERS (BLUE/BLACK) ink only.

Please ensure that all the required sections are completed and all supporting documents are attached as mentioned in each

section and send it to the address given above.

Required Not Required

SECTION B : ACCOMMODATION Minimum 3 months compulsory stay at HIBS

First Name(as) as stated in IC/Passport:

Surname/Family Name as stated in IC/Passport:

Male Female (Tick where applicable)

IC (Only Msian).:

Passport No (Foreign student only) :

Issue Date :

Correspondence/Permanent Address (P.O. Box address is not acceptable for International Applicants):

Expire Date :

City : State : Country : Post Code :

Mobile Phone No :Home Telephone No. (Please include all international codes):

Email :

For International applicants onlyMalaysian Immigration Pass held :

For Applicants from the People’s Republic of China only

Please advice which Malaysian Consulate you wish to obtain your single entry visa into Malaysia :Shanghai Beijing Guangzhou

Malaysian PR Social VisitSocial VisitWork Permit Other (please soecify) :

Student Dependent Diplomatic MM2HNone

Immigration Pass expiry date (dd/mm/yy) :

SECTION C : STUDENT INFORMATION

Name of Parent/Guardian :

Relationship :

Parent/Guardian Address (if different from above) :

City : State : Country :

Occupation :

SECTION D : PARENTS INFORMATION

SECTION E : STUDENTS ACADEMIC QUALIFICATIONS

Post Code :

Home Telephone No. (Please include all international codes) : Mobile Phone No. :

Email :

If space given is insufficient, please include an attachment.Academic Qualifications (Include last school attended and examinations taken)

Attach certified true copies of your school and public examination results.

Please complete the table below and enclose a copy of your English language qualification.

English Qualification (e.g. IELTS, TOEFL, MUET, SPM, 119) Year obtained score

Start date End date Institution name and location Qualification obtained

SECTION F : EXTRA-CURRICULAR ACTIVITIES

Games / Societies Position Held Level(School, State, National, International etc) Year (yyy to yyy)

SECTION G : MEDICAL HISTORY OF STUDENT

Do you have any existing illness?

English language proficiency

YES NO (Tick where applicable)

* If YES, state name, nature of illness and treatment you are currently receiving.

(if possible, please attach certified copies of student’s medical reports)

Blood group : .................................................. Allergies : ..................................................

..................................................................................................................................................................................................................

..................................................................................................................................................................................................................

Name of Person to contact in an emergency :

Relationship with student :

Address (if different from above) :

City :

Email :

Telephone No. (Please include all international codes) : Fax No. :

State : Country : Post Code :

IC / Passport No :

SECTION H : EMERGENCIES

SECTION I : OTHER INFORMATIONS

SECTION J : HIBS RULES & REGULATION FOR ALL STUDENTS

Will your course be self-financed or sponsored? If sponsored, please provide details of your sponsorship

Is there any other information about you that you would like to furnish us with that would enhance your profile?

...............................................................................................................................................................................................................

................................................................................................................................................................................................................

................................................................................................................................................................................................................

Where did you learn about Highlands International Boarding School at Genting Highlands?

Advertisement Agent Personal recommendation Internet University brochure

Other ............................................................................................................................................

1. HIBS POLICY OVER SUBJECTS REGISTRATION

2. ATTENDANCES AND RESULTS

3. ATTIRE

Self : or Organisation / Government sponsor : .......................................................................................................................

Any subject changes made are allowed within 20 working days from the date of commencement of course (CAL).Enrolment and cancellation of the registered subject after the stipulated period is subject to the approval from theDirector of Studies.

It is mandatory to maintain the following regulations by Ministry of Education Malaysia (MOE) / HIBS :To attend all compulsory subjects stipulated by MOE.To attend all lectures, tutorials, practical, weekly exams and other classes as required by the program.To maintain 80% of class attendance for each subject per semester, failing which, you will be barred from the final examinations.To attend all compulsory special extra classes if your weekly exam marks are below satisfactory.

Descent formal / casual wears.

Name of family physician ( or attending Doctor/Clinic/Hospital) :

Address :

City : State : Country : Post Code :

Telephone No. (Please include all international codes):

Email :

Fax No.:

4. YEARLY CLIMATE CHARTIn Malaysia, we do not have distinct seasons but the hot months are during June, July, August and rains during themonth of December, January and February. In Genting Highlands where the school is located we have a very pleasant climate where we experience spring temperatures whole year around.

5. BOOKS & LEARNING MATERIALSAll books and learning materials will be paid by the students.

6. STUDENTS’ ROOM

7. PANTRY

8. MEDICATION

9. MUSICAL INSTRUMENT

All essential furnishing are available.

Only Kettles and Fridge are available in the pantry on every floor for student’s use. The school discourages cookingin the pantry for safety reasons.Please note that HIBS are culturally sensitive in relation to food. We therefore disallow Beef, Pork and non-halal foodwithin the school premises.

All medications must be surrendered to the Matron and detail medical history of the student must be disclosed to theschools authorized Medical Assistant / Matron.

There is an Electric Piano in block A and an upright Piano in Block B available for students use and practice. Studentsmay bring their own instruments e.g. Guitar, Harmonica to play in the Music Room.

Students’ room are furnished with cot, pillow, mattress and study table with shelves and a cupboard.

10. BARRED ITEMSThis list is for general reference only. If there are any further inquires, please refer to the House Master / HouseMistress for a copy of the Rules and Regulations for the residents in the Halls of the Residence.Computer games, jewellery and luxury items.Electrical immersion heaters, irons, electric kettles and other electrical appliancesAll items that can cause harm or endanger the development of a healthy selfChewing gum is strictly forbidden (junk food and instant noodles are discouraged)Mobile phones, laptops, computers brought in must be declared. Usage of the items shall be decided by the HouseMaster as a privilege and not as a right.In the line with our emphasis on simplicity we advise that clothing should not be very expensive as the claim for thelaundry contractor cannot exceed RM25.00.Students are not encourged to keep money in their possession more than the recommended amount. Moneyabove recommended amount, should be handed over to House Master for safety purpose.

INTERNATIONAL STUDENT’S RULES & REGULATIONS

1. Students visa Application. Your acceptance to HIBS is subject to the approval of your student visa application by HIBS & the

Immigration Department Malaysia. HIBS will not be held responsible for the time taken to process your application and/or

rejection of your application by the relevant authorities.

2. Validity of Passport & Pass. You must hold a valid passport and student pass for the entire duration of your stay in

Malaysia. You are responsible for the validity of any kind of immigration pass / and must abide by the rules and regulations

imposed by HIBS and the Immigration Department Malaysia.

3 Report to HIBS. You are required to report to the Office of HIBS within 3 days of your arrival, to pay all outstanding fees,

to proceed for medical examination and submission of passport for endorsement of student pass.

4 Payment of Fee. You are required to report to the Finance and Admissions department to pay the program fee and to present

the original certificate (s) and supporting documents within 7 days after the commencement date of the course (CAL)

5. Payment of Insurance. Medical Examination, Student Pass & Personal Bond. You shall bear all charges related to your

insurance / medical examination / student pass / personal bond or penalty charged by EMGS & the Immigration Department

Malaysia.

6 No Employment. You are not allowed to engage in any kind of work or occupation in Malaysia while holding a student

pass unless you have obtained the approval from the Immigration Department.

7 Extension of Student Pass. You are required to pay RM 2,000 Advance Fee before applying to extend your student pass.

All application for student pass must be submitted to the Office 2 months before the expiry date of your student pass.

8. Withdrawal. You must inform HIBS in writing if you wish to withdraw from the institution and report to the Office for

cancellation of your student pass. HIBS reserves the right to forfeit the caution fee and inform the Immigration Department to

cancel your student pass if you fail to do a proper cancellation before leaving the country.

9. Inactive. If you have registered but fail to attend any classes 1 month after the commencement date without informing HIBS

officially, you will be classified as withdrawn. All fees and security deposit will be forfeited and HIBS will inform immigration to

cancel your student pass.

10. Code of Conduct. You are required to abide by the HIBS Code of Conduct, Code of Discipline and HIBS Student Handbook. Students must abide and be bound by ALL applicable laws in Malaysia. This is regardless of whether the student has acquainted themselves to such regulations. HIBS reserves the right at any time to elect new rules and regulations, to amend existing rules and regulations which shall take effect retrospectively and students are further advised to refer to the students Handbook regurlarly for such amendments.

I have read and fully understand the terms and conditions and effects there of listed in Section H. I hereby specifically confirm my agreement. I further undertake to abide by all such obligations and/ or comply with all terms and conditions set out in Section H on my part to be performed with all payments as agreed. I agree that any offer of placement is conditional on the accuracy of the information provided by me and upon my meeting the minimium pre-requite results to enter into such program.

SECTION K : STUDENT’S DECLARATION

SECTION L : CHECKLIST OF ESSENTIAL THINGS TO BRING

SECTION M : LETTER OF CONSENT (HIBS) / PARENTS / GUARDIAN SAMPLE SIGNATURE

Signature of Applicant

Date : ......... / ....... / .......

........................................................... ...........................................................Signature of Parents / Guardian

1. Blanket - 1 piece, 2 pillowcases and 2 bed sheets (for single bed).2. Toiletries - Toothbrush, toothpaste, bathing soap, tissue paper, shampoo, small mirrior etc.3. Casual Wears: i. BOYS - Short and long sleeve shirts and plain trousers. ii. GIRLS - Dresses, blouses, skirts and other suitable evening wear. Students are required to be neatly and smartly dressed when they are in the school’s premises.4. Footwear - School shoes - 1 pair (Boys & Girls will wear flat bottomed normal black leather shoes which are not fanciful). Sport shoes - 1 pair for indoor games (they should be of plain shoes and not coloured to prevent markings on the floorings) and 1 pair for outdoor games. Slippers - 1 pair for bathroom use.5. Umbrella / raincoat - 1 piece. Plastic pail - 1 medium size, laundry powder - 1 small packet.6. Swimming costumes / trunk and swimming cap.7. Mug and spoon, water- bottle and clothes’ hanger.8. One medium size padlock with duplicate keys.

Signature of Parent / Guardian Signature of Parent / Guardian

I, the undersigned, give my consent for my daughter / son / ward ...........................................................................................................IC / Passport No ......................................................................... to study at Highlands International Cambridge A’ Level atHighlands International Boarding School with effect from .....................................until .......................................................

...................................................................... ......................................................................

Date : ....... / ........ / .....Name : ................................................................................

.........................................................................................................................

SECTION N : PAYMENT

SECTION O : ACCOPANYING DOCUMENTS

1. Completely filled Application Form

2. Document checklist for Malaysian applicants

i. 2 copies of IC

ii. 6 passport size photos

iii. 1 certified true copy of ALL academic certificates & transcripts

iv. Certified forecast results / SPM / IGCSE / CBSE / Other Equivalent

3. Document checklist for International applicants

i. 3 copies of passport (all pages, detail page (s) in colour, 2 years validity)

ii. 6 passport photos (blue background)

iii. 3 certified true copies of ALL academic certificates & transcripts

iv. Original NOC / Eligibility Letter

v. Payment of EMGS fee and registration fee

4. Parent / Guardian consent letter

5. 1 copy of both parents’ identity card / passport

6. 2 copies of passport size photos (both parents)

7. Photocopy of student’s birth certificate

8. 1 copy of student’s school leaving certificate

9. Enclose with a sum of RM500 cash / cheque (Non-Refundable) towards the Registration Fee.

Application Form and all documentation should be sent to the folllowing address:

A’ Levels Admission Officer

10 KM, Genting Highlands, 69000 Genting Highlands, Pahang Darul Makmur, Malaysia.

Tel : 03-6100 1688, Fax : 03-6100 3688 Eimail : truealevel@gmail.com

Student I.D. :

Category of Acceptance : Accepted : Conditional Acceptance : Rejected :

Entry date :

Academic requirements for Conditional Acceptance

Other Conditions : ...................................................................................................................................................................

Remarks : ...............................................................................................................................................................................

Check by : ............................................................................. Signature : ...........................................................

Recruited by : Friend to friend Introducer’s name : .........................................................................................

Others

Agent Company name & stamp : Admission Process by :

Signature: .......................................................................................................

SECTION P : FOR OFFICE USE ONLY

I enclose herewith a sum of RM500 cash / cheque (Non-Refundable) towards the Registration Fee for this application. Fees are

payable by cash, cheque or bank draft. Cheques or Draft should be crossed and made payable to : HIGHLANDS INTERNATIONAL

BORDING SCHOOL”.

Date : ........ / ....... / ....... Cheque / Receipt No : ..............................................................