APELUGM

APEL CENTRE
Lot 6-3-8, 3rd Floor Prima Peninsula
Jalan Setiawangsa 11 Taman Setiawangsa
54200 Kuala Lumpur
apel@geomatika.edu.my / +603-42664263

Application Form

Name

Correspondence Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Contact

Mobile Number

Work Number

Personal Details

IC/Passport Number

IC/Passport Photocopy

Date Of Birth

Gender

Highest level of academic qualification obtained

Name of Academic Qualification obtained

Upload Proof of Academic Qualification obtained

Upload Resume / CV

Application Details

Institution / University to apply for

Course Name to apply for

Level of study to apply for

Field of study to apply for

I hereby declare that all the information/documents provided to support this application are authentic, true and accurate. I fully understand that UGM APEL Centre reserves the right to reject my application if proven otherwise.