Edit your Form

Step 1
APPLICANT'S PARTICULARS


Uploaded Applicant Image :


(Image Size between 50kb to 100kb)



UNIVERSITY / COLLEGE DETAILS




Yes :
No :
Yes :
No :

FEES STRUCTURE




Step 2
CONTRIBUTION FROM OTHERS TO APPLICANT'S (RM)
PARENTS / GUARDIAN /FAMILY RELATIVES / FRIENDS PTPTN SCHOLARSHIP OTHER LOANS
APPLICANT�S PARENTS / GUARDIAN�S PARTICULARS
DETAILS FATHER MOTHER GUARDIAN
Name (as per I/C)
Permanent Address
Postcode
City
State
Occupation
Place of Employment & Address
Income (per month)
Telephone No
Email Addresss

Income of Applicant's Parents / Guardian from Other Sources:
Amount Per Month:
Step 3
APPLICANT�S HUSBAND / WIFE PARTICULARS
DETAILS HUSBAND / WIFE
Name (as per I/C)
Permanent Address
Postcode
City
State
Occupation
Place of Employment & Address
Income (per month)
Telephone No
Email Addresss
PROPERTY OWNED BY APPLICANT'S PARENTS / GUARDIAN (MOVABLE AND IMMOVABLE)
SN.No. DETAILS OF PROPERTY ADDRESS VALUE INCOME DERIVED PER MONTH
1
2

APPLICANT'S PARENT'S DEPENDENTS OTHER THAN APPLICANT
SN.No. NAME AGE RELATION TO PARENTS / GUARDIAN SCHOOLING / COLLEGE
1
Step 4
SELF SUPPORTING BROTHERS / SISTERS OF APPLICANT'S (INCLUDING BROTHERS / SISTERS IN LAW)
SN.NO. NAME OCCUPATION INCOME PER MONTH (RM) MARITAL STATUS NO. OF CHILDREN LIVING WITH PARENTS AMOUNT CONTRIBUTION TO APPLICANT
1

State Briefly Any Other Reasons In Support Of This Application:

Please name two Referees who are not related to you and to whom reference may be made for a report about your circumstances:

DETAILS REFEREE 1 REFEREE 2
Name (as per I/C)
Permanent Address
Postcode
City
State
Occupation
Place of Employment & Address
Income (per month)
Telephone No
Email Addresss




The Surety must be a person unrelated to the Applicant and acceptable to the Board with a regular income of not less than $1,500/- per month:

DETAILS SURETY 1 SURETY 2
Name (as per I/C)
Permanent Address
Postcode
City
State
Occupation
Place of Employment & Address
Income (per month)
Telephone No
Email Addresss
Signature (Surety 1):

Signature (Surety 2):



Date (Surety 1):

Selelcted Date : 0000-00-00

Date (Surety 2):

Selelcted Date : 0000-00-00


Declaration by Applicant

I declare that all particulars given herein are true and complete and if there are any changes to my personal particulars/university/college details, I undertake to inform KWBTSM as soon as possible.

Signature :

Date :

Selelcted Date : 0000-00-00


Declaration by Parents / Guardian

I declare that to the best of my knowledge, all the particulars given by the Applicant, who is my son/daughter,are true and complete and I undertake to inform KWBTSM of any changes to personal particulars/university college details.

Signature :

Date :

Selelcted Date : 0000-00-00

Step 5
Required Documents
Kindly take note that you are required to send your application form together with your supporting documents for our needful action.
DOCUMENT REQUIRED YES NO
Student I/C copy

Birth Certificate copy
Student 1 Passport Size Photo



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Photo size between (10kb to 50kb)
Student ID Card ( Matric Card ) copy

SPM / STPM / SPV / Foundation / Diploma / Others Certificate copy

Offer Letter copy

Applicant Parents I/C copy and pay slip

Applicant Parents current three month pay slip

Statement of Bank Account copy (Repayment Payee Bank Account)

Sureties I/C copy (2 Person)

Sureties current three month pay slip (RM 1,500 above) (2 Person)