ApplicationRef. No

ENROLMENT FORM

(1) PERSONAL DETAILS:

Title (Mr. Ms. Mrs) _____________________________________________

Surname: _____________________________________________

First Name (s): _____________________________________________

Date of Birth: __________________ Sex: M F

Nationality: _____________________________________________

Passport No./ NIRC No.: ______________________ Marital Status: __________

Correspondence

Address ______________________________________________________________

______________________________________________________________

______________________________________________________________

Telephone No. (s) ______________________ Facsimile No. (s): ________________________

Handphone: ______________________ Email:

_________________________________

PermanentAddress (if different from the above):

Name andAddress of Company:

Profession:

Programme: MBA Comprehensive & Practical Model (100% On-line) offered by Pebble Hills University, Ca., USA

How did this MBA programmes come to your notice? ______________________________________

Payment Method Scheme: (tick one) Full Payment Route Modular Payment Route

______________________________________________________________

______________________________________________________________

______________________________________________________________

______________________________________________________________

MASTER OF BUSINESS ADMINISTRATION

(2) ACADEMIC RECORDS:

a) Please list all past schools, colleges and universities attended, professional qualification or other qualifications

with the most recent first.b) Please attach all necessary documents especially transcripts (copies only).c) Use additional sheets if necessary.

Give details of all current examinations and/ or courses you are taking.

From ToSchool/ University/ College/ Professional Body/ Others

Class/ Grade/GPA avg.

DateQualificationObtained

College/ University Body Description (course/ examination)Expected date of

completion

(3) CAREER HISTORY

A: WORK EXPERIENCE

1) Please give details of your employment history, with the most recent first.2) Please attach certificate of employment and description of job duties for each job title.3) Use additional sheets if necessary.

B. FIELD EXPERIENCE

1) Please give details of the training, seminars, talk, symposiums, community service and others, with the most recent first. 2) Please attach appropriate certificate.3) Use additional sheets if necessary.

From ToReason for

leavingDate

Organisation Job Title

No. of daysTitle of training/ seminar/ talk/ symposium/ serviceConducted by

(Give Organiser's name)

Course fee (non- refundable)*

1 copy of all relevant documents (All cheques must be made payable to “TNI Consultancy” and crossed

“A/c Payee”)

(4) ENCLOSURES

DISCLAIMER Training Provider

TNI Consultancy (TNI) is an independent, self- financing and do not come under the jurisdiction of any government body. Quality Assurance

All assignments (if any) are verified by an PHU’s verifier whose role is to ensure that the minimum standards are met. Accreditation TNI is affiliated to PHU and is authorised to offer their various MBA /DBA degree courses to all working adults who meet their qualification criterias.

The Programmes

TNI with its partnership status with PHU, offers working adults an excellent opportunity to become MBA/DBA degree holders through flexible work- based on-line distance learning modules.  Recognition

Pebble Hills University is accredited by International Accreditation Organization (IAO) for achievement of highest standards in Organizational Management, Business Management and Business Performance through a commitment to quality and continuous improvement in Education. IAO is associated with world's leading and nationally recognized quality assurance agencies worldwide for betterment of educational standards. Some of the current IAO partners are : Department of Adult & Higher Education, Ministry of Education (Bhutan), The National Commission for University Evaluation and Accreditation (Argentina), The National Higher Education Accreditation (Costa Rica), The Accreditation and Quality Assurance Commission (Palestine), The Agency for Development of Higher Education and Quality Assurance (Bosnia and Herzegovina), Accreditacion Agencia (Chile), The Quality Assurance & Accreditation Council (Sri Lanka), Public Agency for accreditation of Higher Education (Albania), Center for Quality Assurance and Accreditation for HEI (Libya) and Higher Education Quality Evaluation Centre (Latvia), etc. International Education Accreditation Commission recognizes IAO's accreditation standards.  Non- refundable PolicyThe course fees are not refundable for any reason(s) whatsoever..

DECLARATION

I,__________________________________________, NIRC No. ________________________________have read and fully understood all the information contained herein and do hereby fully agree to covenantwith TNI with full knowledge, and confirm that all information given on this form is complete and correct.

I also agree to:- i) Abide by TNI consultancy’s Policies, Rules and Regulations at all

times.

ii) Pay all fees as required on time.

iii) Accept that TNI Consultancy reserves the right to amend or add to

existing policies, fees, rules and regulations as it deems fit.

iv) Accept that TNI consultancy reserves the right to revise current fees

from time to time, giving one month advance notice.

Signature:

_______________________________________

Date:

Approval Code:TNI- ILM No._______________

June 2014