UOWMKDU | Pre University Scholarship

Fields marked with (*) are required to be filled.

Academic Programmes

Preferred Programme *

Intake

Have you applied for other scholarships?

No Yes

PERSONAL INFORMATION

Name as per NRIC/Passport *

NRIC No./Passport No.*

_{e.g: 800810085667}

Gender *

Male Female

Student No.

_{(KDU Student only)}

Nationality *

Bumiputra Non-Bumiputra International

Race *

Address *

Country *

State *

Town/City *

Contact No. *

_{e.g: +601345678901}

Email Address *

Family Members * — Parents/Guardians and Siblings/Other Dependents.

Name (as in NRIC)	Relationship	Age	Occupation	Monthly Income

Note: Please produce certified true copies of relevant documents at the scholarship interview. This information will be treated with strict confidentiality.

EDUCATIONAL BACKGROUND *

Name of School
Address
Year of Examination
Highest Academic Qualification
Overall Grade/Aggregate

SPM MID TERM / O-LEVEL TRIAL RESULTS

Subjects	Mid Year Results	Trial Results

Note: Please provide certified true copies of examination certificates and result transcripts at the scholarship interview.

EXTRACURRICULAR ACTIVITIES

Name of Club/Society/Association/Activity/Event	Position	Year	Special Achievement (if any)

Note: Please provide certified true copies of examination certificates and result transcripts at the scholarship interview.

I HAVE READ, UNDERSTOOD AND ACCEPTED THE PERSONAL DATA PROTECTION NOTICE (PDPA). *

I DECLARE THAT ALL INFORMATION I HAVE PROVIDED ON THIS ONLINE FORM IS ACCURATE AND TRUE. *