Monash Mbbs

7/31/2019 Monash Mbbs

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Bachelor of Medicine/Bachelor of Surgery (MBBS)

Application for admission (Please state year)

Applicant Name:

Instructions:

Please fill out this form clearly in pen. Prospective students are encouraged to apply online at

www.monash.edu.my/advancement/future/

Enclose all supporting documentation with this application. (All documents must be certified by a recognised authority).

This application will not be processed unless full documentation is attached.

An application fee of RM100 (non-refundable) is payable on submission of this form. Bank draft is to be made payable to

MONASH UNIVERSITY SUNWAY CAMPUS. Cash is only payable at the Financial Services Cashier Counter.

You are required to refer to the Monash University Sunway Campus website at www.monash.edu.my/advancement/future/ for

admission deadlines.

(For international students only) Please note that strict deadlines have been set for international student applications to facilitate the student

pass processing. If the student pass application is successful, a Letter of Approval(from the Malaysian Immigration Department) will be

sent to you. Only students who hold a valid student pass will be permitted to enroll and commence classes.

This application is the property of Monash University. Supporting documentation will NOT be returned.

It is your responsibility to advise Monash University Sunway campus regarding any change of address.

Send your application to:Prospective Students Office

Monash University Sunway campus,

Jalan Lagoon Selatan, Bandar Sunway

46150 Petaling Jaya

Selangor Darul Ehsan, Malaysia

Telephone +603 5514 6000

Email [email protected]

Website www.monash.edu.my

Office use only

Finance

Application No:

International Student Pass Unit:

ID No: Course Code:

Offer Acceptance Date:

Prospective Students Office Student Recruitment

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www.monash.edu.my MSC StatusCompanyM E M B E R

D D M M Y Y Y Y / / D D M M Y Y Y Y / / D D M M Y Y Y Y / /

Section A: Your application

1. Are you a Malaysian Non-Malaysian

2. The application form was submitted by (please tick appropriate box)

Self (direct application). Where was this application submitted?

Monash representative/agent. Name of Monash representative/agent

Other (eg. sponsor JPA, MARA, etc.) - attach supporting documentation. Name of other

Acknowledgement of receipt Official reply to applicant

Date Date

Reply to agent

Date faxed


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Section B: Personal details (Please state name as per passport)We may contact you by email, post or telephone. To avoid delays in your application, it is important you complete ALL your details including your email address.

Title: (eg. Mr, Ms, Mdm)

Given name/s

NRIC/Passport number

Date of Birth*

Nationality

*Religion* For government reporting only.

Family name/Surname

Sex

*Note: Please refer to the University age requirements for admissions at

www.monash.edu.my/advancement/future/

Male Female

Muslim Buddhist Hindu Christian Other. Please specify:

Country of Birth

Section C: Visa related information (for international students only)

D D M M Y Y Y Y

D D M M Y Y Y Y

D D M M Y Y Y Y

Are you currently in Malaysia?If YES, please state your pass type (eg. student, dependent) :

Yes No

Yes No

When does this pass and/or visa expire?

Section D: Postal address for correspondence (or agents address where applicable)

Number & Street

City/Town

Country

Phone (Home)

Mobile number

Email address (agent)

State/Region

Postcode

Phone (Office)

Fax

State/Region

Postcode

Phone (Office)

Fax

Home address (essential)

Number & Street

City/Town

Country

Phone (Home)

Mobile number

Email address (own)*

* Compulsory

Section E: Academic qualifications and other required documents

Secondary studies

Part 1: SPM/O-Levels/Year 11 or equivalent - Please provide 2 certified copies of academic transcripts/ results

Year obtained:

Assessment / qualification type (eg. SPM/O-Levels/Year 11):

Name of school/institution:

State / Country:

Part 2: A-Levels /Year 12 or equivalent (eg. Pre-U) Please provide a certified copy of academic transcripts/ results

Year obtained:

State / Country:

Assessment /qualification type (eg. A-Levels/CIMP/MUFY/etc):

Are you currently awaiting results of any secondary or Pre-U studies?

If yes, name of qualification and institution:

Date on which the results will be available:

Score / Result:

Name of institution:

Bachelor of Medicine/Bachelor of Surgery (MBBS) Application for Admission


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Tertiary studies

Section F: Statement of activities and other academic studies

Section G: Employment history

Section H: English language proficiency and aptitude test

Occupation / Position:

Start date:

Employment type:

Position and duties:

Please provide details of any employment experience that may be relevant to the course application.

Supporting documentation (ie. CV or references) may be submitted. Please use additional pages if space below is insufficient.

Occupation / Position:

Start date:

Employment type:

Position and duties:

End date:

Employer name:

Studying or studied English or ESL as a pre-university subject.

English was the language of instruction in previous studies completed.

Will sit/have sat for English language proficiency test (eg. TOEFL, IELTS). Date scheduled/taken

English test name (if known):

Result (if known):

IELTS candidate ID:

Will sit/have sat for ISAT aptitude test (this is a requirement for entry). Date scheduled/taken

Result (if known):

ISAT candidate ID:

Other/provide details

(Please note that this will not satisfy the English requirements for the MBBS)

(result certificate required)

(result certificate required)

Yes

Yes

No

No

Yes No

YYY YMMD D

YYY YMMD D

YYY YMMD D

YYY YMMD D

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FT PT

Institution:

Year last attended (MM/YY):

Did you complete?

End date:

Employer name:

Please submit a certified copy of academic transcripts /results for ALL qualifications/academic studies, either currently enrolled,

completed or discontinued, including failures (if any). Please use additional pages if space below is insufficient.

Degree / qualification:

Field of study/ Major/ Specialisation:

Year commenced (MM/YY):

State/Country:

Are you currently awaiting results of any post secondary or professional or tertiary studies?

If yes, name of qualification and institution:

Date on which the results will be available:

Have you engaged in or do you intend to study at another institution in Malaysia or overseas for the period from

your last/most recent academic studies to the commencement of the intended intake?

If YES, please state what activities you have/will engage in during this period.

If NO, please state what activities you have engaged/will engage in during this period.

Bachelor of Medicine/Bachelor of Surgery (MBBS) Application for Admission


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Documents

Monash Mbbs