SIDMA Online Application Form
 
Required fields are marked with an asterisk * | Click Here For Malaysian Students
Current Qualification*
Choice of Campus*
1st Choice*
2nd Choice*
3rd Choice*
Full Name*
Date of Birth*
Gender*
Place of Issue*
Identify Card Number*
e.g: 810115-12-5723
Race*
Citizenship*
Fax Number
Religion*
Marital Status*
Telephone Number*
    
 
Permanent Address
Address*
Postcode*
District*
State*
Country*
 
Family Particulars
Name of Father / Guardian *
No. of Dependent *
Identity Card Number *
Office Address *
Citizenship *
Occupation *
Telephone Number *
Monthly Income *
Fax
 
Academic Qualifications (O-Level/High School Diploma/A-Level/UEC)
School Name *
Year *
Full Result *
Subjects
Grade
Additional Info
1)
2)
3)
4)
5)
6)
7)
8)
9)
10)
 
English Language Proficiency
English Language Proficiency * Grade Year
 
University / College Qualifications
No
University / College
Certificate
Programme
Result (CGPA)
Duration
Graduation Year
1
2
3
 
Working Experience
No
Job Title
Organization
Start Date
End Date
1
2
3
 
Declaration As to Fitness

Do you suffer from any physical disability or illness? If so, please spesify the nature of these conditions. Otherwise please choose None:

OKU Registration No:

 
Email Address*
(If you are using FREE Email such as Yahoo, Gmail & Hotmail, please add our email address (info@sidma.edu.my) in your contact list to receive our reply. Our reply might be sent to the spam box if you do not do this)

I attest that I have personally filled in this form and the information contained herein is complete and accurate to the best of my knowledge. I understand that witholding information of giving false information will make me ineligible for admission and future enrolment. I further understand that I may be required to appear for an interview or to undergo such test that may be requested by the University as a condition for admission to the programme of study for which I have applied.