SIDMA Online Application Form
 
Required fields are marked with an asterisk * | Click Here For International Students
Current Qualification*
Choice of Campus*
1st Choice*
2nd Choice*
3rd Choice*
Full Name*
Date of Birth*
Gender*
Place of Issue*
IC Number*
e.g: 810115125723
Race*
Citizenship*
Fax Number
Religion*
Marital Status*
Telephone Number (e.g: 087293923 / 0168394893)*
    
 
Permanent Address
Address*
Postcode*
District*
State*
Country*
 
Family Particulars (Please fill in all the required fields completely. DO NOT put NONE or Leave any required field blank or your form will be rejected)
Name of Father / Guardian *
No. of Dependent *
IC Number *
Office Address *
Citizenship *
Occupation *
Telephone Number (e.g: 087293923 / 0168394893) *
Monthly Income *
Fax
 
Emergency Contact Person (Other than the above)
Full Name *
Relationship *
IC Number *
Contact Address *
Telephone Number *
   
 
Academic Qualification (SPM / SPMV / O-Level)
School Name *
SPM Year*
SPM Aggregate*
 
SPM Grade*
Bahasa Melayu (Malay)
Science (Sains)
Bahasa Inggeris (English)
Fizik (Physics)
Agama Islam (Islamic)
Kimia (Chemistry)
Sejarah (History)
Biologi (Biology)
Matematik (Maths)
Ekonomi Asas (Basic Economic)
Matematik Tam. (Add Maths)
   
Other SPM Result

eg: Bahasa Mandarin (A1), Bahasa Tamil ( C6) (Seperate each subject with a comma)
 
Academic Qualification (STPM / A-Level / UEC) Grading Scheme for STPM Starting 2003: Principal Passes Are A+, A, A-, B+, B, B-, C+, C )
STPM Year
Principal
Subsidiary
 
General Paper
Mathematics
History
Kesusasteraan Melayu
Economic
Bahasa Melayu
Other STPM Result


eg: Bahasa Mandarin (A1), Bahasa Tamil ( C6) (Seperate each subject with a comma)

 
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.