COURSES AVAILABLE

BUSINESS & ACCOUNTING Accounting & Finance • Management • General Management • Supply Chain Management • Business Administration • Marketing • Human Resource Management ENGINEERING & BUILT ENVIRONMENT Mechanical Engineering • Electronic & Electrical Engineering • Chemical Engineering • Civil Engineering • Construction Management • Environmental Technology TECHNOLOGY Information Technology • Information Systems Management • Computing • Applied Business Computing • Multimedia HEALTH SCIENCES Medicine • Optometry • Pharmacy • Dentistry ALLIED HEALTH SCIENCES Nursing • Environmental Health • Medical Laboratory Technology • Psychology CREATIVE ARTS & DESIGN Advertising Design • Creative Multimedia • Graphic Design • Interior Design • Mass Communication • Music • Photography • Video & Animation EDUCATION & SOCIAL SCIENCES Early Childhood Education • Montessori Pedagogy HOTEL & TOURISM Hotel Management • Tourism Management POSTGRADUATE STUDIES Doctor of Business Administration (DBA) • Master of Business Administration (MBA) AMERICAN DEGREE PROGRAM Psychology • Communications • Finance • Management • Marketing • Human Resource Management • Business Administration • International Business FOUNDATION Science • Commerce • Information Technology • A-Level PROFESSIONAL STUDIES ACCA • LCCI • ABE • CEH • CHFI

Department of International Offi ce

世纪大学学院SEGi University CollegeKP/JPS/DFT/US/B24

No. 9, Jalan Teknologi, Taman Sains Selangor,Kota Damansara, PJU 5, 47810 Petaling Jaya, Selangor

Tel: 03-6145 1777

Fax: 03-6145 1666

E-mail: infokd@segi.edu.my

TOLL FREE: 1800-88-7344

吉隆坡世纪学院SEGi College Kuala LumpurJPWP178

Bangunan SEGi, 33-35, Jalan Hang Lekiu, 50100 Kuala Lumpur.

Tel: 03-2070 2078

Fax: 03-2034 2759

E-mail: infokl@segi.edu.my

TOLL FREE: 1800-88-8028

首邦再也世纪学院SEGi College Subang Jaya B4P8001

City Campus, Persiaran Kewajipan, USJ 1,47600 UEP Subang Jaya Selangor D.E.

Tel: 03-8600 1888

Fax: 03-8600 1999

E-mail: infosj@segi.edu.my

TOLL FREE: 1800-88-8622

槟城世纪学院SEGi College Penang187620-W

Wisma Greenhall, 43, Green Hall, 10200 Penang

Tel: 04-263 3888

Fax: 04-262 2193

E-mail: infopg@segi.edu.my

砂拉越世纪学院

SEGi College Sarawak IPTS/SV.1031/42/98

211 Jalan Bukit Mata Kuching, 93100 Kuching, Sarawak

Tel: 082-252 566

Fax: 082-231 355

E-mail: infoswk@segi.edu.my

TOLL FREE: 1-300-88-7344

Please affi xa passport– sizedphotograph

Name of Applicant (as per Passport)

Name in Chinese (if any)

Passport No.

Please use BLOCK LETTERS to complete this form:

Programme:

Intake: Year:

Campus: SEGi University College, Kota Damansara SEGi College Kuala Lumpur SEGi College Subang Jaya

Student Particulars

Passport Expiry Date (dd/mm/yy)

Nationality

Email

Country of Birth

Gender

Male Female

Marital Status

Single Married

Date of Birth (dd/mm/yy)

Religion

Male Female Male Female

Campus: SEGi University College, Kota Damansara SEGi College Kuala Lumpur SEGi College Subang JayaCampus: SEGi University College, Kota Damansara SEGi College Kuala Lumpur SEGi College Subang JayaCampus: SEGi University College, Kota Damansara SEGi College Kuala Lumpur SEGi College Subang Jaya

Single Married Single Married

SEGi International Agent:

www.segi.edu.my

INTERNATIONAL STUDENT APPLICATION FORM

Contact Address while studying in Malaysia

Address Tel

Fax

Mobile PhonePostcode City State CountryPostcode City State CountryPostcode City State CountryPostcode City State Country

Permanent Home Address at country of origin (for correspondence purpose)

Address Tel

Fax

Mobile Phone

Postcode City State CountryPostcode City State CountryPostcode City State CountryPostcode City State Country

Parent/Guardian/Sponsor Particulars (in case of emergency)

Full name Parent / Guardian

Correspondence Address Tel

Fax

Mobile Phone

Postcode City State CountryPostcode City State CountryPostcode City State CountryPostcode City State Country

Qualifi cationsSchool/Institution/University Qualifi cation From ToSchool/Institution/University Qualifi cation From ToSchool/Institution/University Qualifi cation From ToSchool/Institution/University Qualifi cation From To

Work Experience (if any)

Company Position From ToCompany Position From ToCompany Position From ToCompany Position From To

Declaration

I declare that the information provided by me in connection with this application is true and correct. I undertake to inform SEGi College / SEGi University College immediately of any change in address, phone number and/or other information provided by me in this application.

I understand that SEGi College / SEGi University College reserves the right to vary or reverse any decision regarding admission or enrolment made on the basis of incorrect or incomplete information. I agree to be bound by the Terms and Conditions of the offer to study at SEGi College / SEGi University College.

Signature of Applicant: Date: Signature of Applicant: Date:

FOR OFFICE USE ONLY

Counselled by Date

Remarks

Please send the Visa Approval Letter (VAL) toName of student / Agent Representative:Address: Post Code:Country: Tel: Email:

Counselled by Date

Admission

Approved by Date

Full Offer Conditional Offer Reject

Remarks & Recommendations

Approved by Date

Bursary (Fees paid are Non-Refundable)

Full Offer Conditional Offer Reject Full Offer Conditional Offer Reject Full Offer Conditional Offer Reject

Fees paid Application Security Deposit Facility Charges Tuition Others

Application Application Security Deposit Facility Charges Tuition Others

AmountCheque No.CashTelegraphic TransferCredit Card

Receipt No.

Processed by

Date

Post Code:Country: Tel: Email:Country: Tel: Email:

Admission Procedures for SEGi

1. Complete the i) SEGi International Student Application Form & ii) University Form (If Applicable)

2. 1 photocopy of passport (all pages including blank pages) Passport must have at least 6 - 12 months validity. *Please ensure that the front page and other information of the student is CLEARLY shown.

3. 6 recent passport size photographs (4cm x 5.5cm) with name and passport number written on the reverse sides.

4. Certifi ed true copies of applicant’s academic qualifi cation(s) in original language and English translated version.

5. Certifi ed copy of evidence of your English language profi ciency (if applicable)

6. Completed Medical report

7. To claim for exemption - provide Transcript and Syllabus / Course outline of your previous qualifi cation(s).

8. Application processing fees of RM1800 (RM300 Application Fee + RM1500 Visa Application Fee), via bank draft or EFT, should be made payable to relevant campus (details as given below).

9. Write-up of 150 words of work experience and curriculum vitae (if applicable) for MBA / DBA applicants

10. Certifi ed true copies of academic certifi cate / transcript.

Accommodation Required

Bank Details

Benefi ciary Name : SEGi University College (M) Sdn Bhd Banker’s Address : Damansara Utama (Uptown Branch) Selangor, Malaysia

Bank Name : OCBC Bank (Malaysia) Berhad Swift Code : OCBCMYKL

Benefi ciary Bank Account Number : 707-105-9595 (OCBC Bank) Benefi ciary Phone Number : 603-61452613 / 603-6145 1643

SEGi College Subang Jaya

Benefi ciary Name : SEGi College (Subang Jaya) Sdn Bhd

Bank Name : OCBC Bank (M) Bhd Subang Jaya Branch

Benefi ciary Bank Account Number : 708-104-9797

SEGi College Kuala Lumpur

Benefi ciary Name : SEGi College (KL) Sdn Bhd

Bank Name : Public Bank Berhad

Benefi ciary Bank Account Number : 308-586-9618

Banker’s Address : OCBC (M) Bhd (Subang Jaya Branch) Selangor, Malaysia

Swift Code : OCBCMYKL

Bank Address : (Hang Lekiu Branch) Kuala Lumpur, Malaysia

Swift Code : PBBEMYKLXXX

Please fi ll in Accommodation Booking Form and submit with necessary booking fees to confi rm a place.Subject to availability.

Yes No

SEGi University College, Kota Damansara