2017 SCHOLARSHIPS & BURSARIES
APPLICATION FORM
 

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


Scholarship Type *
 
Academic Programmes
Programme Name *

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

 
AWARDS/OTHER QUALIFICATIONS
Name of Examination/Award Grade

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.