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EIT - REPLY FORM
Appendix IV
Revision No. : 01Effective Date : 01/11/2009
EIT APPLICATION FORM Important: Please submit an original copy of your partial transcript and resume
to EITU along with this form.
PERSONAL INFORMATION
Name:
Matric No. :Passport/ IC No.:
Nationality:Date of Birth:
Hp No.:E-mail:
Gender: Male Female
Permanent Address :
Tel No.:
ACADEMIC INFORMATION
Programme:
Aerospace Automotive Biotechnology Computer & Information Communication Mechatronics Manufacturing Material
Total Credits Earned (including next Sem. II):
Remaining Credits ( after EIT):
Study Year:
Current CGPA:
EMERGENCY CONTACT PERSON INFORMATION
Name :
Relationship:Tel/HP:
Address:
STUDENTS NAME & SIGNATURE
__________________________
Date
for identification purposes, submit one photograph
OFFICE USE ONLY
Application Status:
Approved Not Approved
Reason:
_______________________________________
___________
Programme Coordinator
Engineering Industrial Training Unit Date:
__________________________
Name:
Date: