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Registration Form

Programme Applied:

 

POSTGRADUATE DIPLOMA OF MEDICAL ULTRASONOGRAPHY (ASIA) - DMU (ASIA)
June intake
November intake
DIPLOMA OF HEALTH SCIENCE - DHS
January intake
March intake
July intake
DIPLOMA OF HEALTH SCIENCE (HEALTH ADMINISTRATION) - DHA
January intake
March intake
July intake
DIPLOMA OF MEDICAL IMAGING - DMI
January intake
March intake
July intake


STUDENT PARTICULAR
Name :
NRIC/Passport No. : NRIC/Passport is required.
Date of Birth
(dd/mm/yy)		 : A valid e-mail is required.
Race :
Religion :
Sex : Male       Female
Marital Status : Single     Married
Email : email is required.


CONTACT ADDRESS
Address :
Postcode : Poscode is required.
City : City is required.
State : State is required.
Country :
Tel :
Fax :
Mobile Phone :


QUALIFICATION
School Qualification Subjects Grade From To
1.

SPM

 1.
2. Grade is required. Grade is required.
3. Grade is required. Grade is required.
4. Grade is required.Grade is required. Grade is required.
5. Grade is required.Grade is required. Grade is required.
6. Grade is required.Grade is required. Grade is required.
7. Grade is required.Grade is required. Grade is required.
8. Grade is required.Grade is required. Grade is required.
9. Grade is required.Grade is required. Grade is required.
           
2.

STPM/A-Levels

 1.
2.
3.
4.
5.
     
Instituition/University Qualification
Course
CGPA
 From To
3.
4.
5.



WORKING EXPERIENCE
Company Position From To
1.
2.
3.
4.

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