Online Application

*Denotes mandatory field which must be completed.

PERSONAL DETAILS

*Title

*Full Name (as stated in the NRIC / Passport)

*NRIC (new) / Passport Number

*Nationality

*Date of Birth

*Gender
Male Female

*Marital Status

*Race

CONTACT DETAILS

*Correspondence Address (This will be used in all correspondence)

*Postcode

*City/Town

*State

*Country

*Email

*Handphone
-

If your current Correspondence address is similar to your permanent correspondence address, please click on this button to

*Permanent Address

Office Telephone
-

Residence Telephone
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*Postcode

*City/Town

*State

*Country

EMERGENCY CONTACT DETAILS

*Name

*Relationship

*Email

*Contact Number
-

* PREFERRED REGIONAL CENTRE:

*INTENDED PROGRAMME OF STUDY

*Program Name

EDUCATION BACKGROUND
(Please list from the highest to the lowest qualification)

Qualification/Achievement

From

Institute

Specialisation

Qualification/Achievement

From

Institute

Specialisation

Qualification/Achievement

From

Institute

Specialisation

Qualification/Achievement

From

Institute

Specialisation

Qualification/Achievement

From

Institute

Specialisation

Qualification/Achievement

From

Institute

Specialisation

Qualification/Achievement

From

Institute

Specialisation

Qualification/Achievement

From

Institute

Specialisation

WORK EXPERIENCE
(Please state the most current one first)

Organisation

Position

From

Knowledge

Organisation

Position

From

Knowledge

Organisation

Position

From

Knowledge

Organisation

Position

From

Knowledge

Organisation

Position

From

Knowledge

Organisation

Position

From

Knowledge

Organisation

Position

From

Knowledge

Organisation

Position

From

Knowledge

WORK EXPERIENCE

(Please state the most current one first)

* denotes compulsory field which must be completed.

DECLARATION:

• I declare that all information given in this application form and the attached documents are accurate and complete.

• I consent that if registered, I will conform to the Constitution and Rules and Regulations of the University.

• I authorize the University to obtain information from any of my previous or current educational institution/employer.

• I understand the University reserves the right to vary, reject or reverse any decision made on the basis of untrue, incomplete or misleading information.

• I give consent to the University to collect and process my personal data in accordance with their policies as per the Privacy Statement published in the University's corporate website (www.wou.edu.my) and the Personal Data Protection Act (2010).

• I acknowledge that it is my responsibility to constantly update myself on the latest information embedded in the Student Handbook and other publications which can be retrieved from the Student Portal (https://my.wou.edu.my)

Select here if you agree to the above declaration