COURSES AVAILABLE

BUSINESS & ACCOUNTING Accounting & Finance • Management • General Management

• Supply Chain Management • Business Administration • Marketing • Human Resource
Management ENGINEERING & BUILT ENVIRONMENT Mechanical Engineering •
Electronic & Electrical Engineering • Chemical Engineering • Civil Engineering • Construction
Management • Environmental Technology TECHNOLOGY Information Technology •
Information Systems Management • Computing • Applied Business Computing • Multimedia
HEALTH SCIENCES Medicine • Optometry • Pharmacy • Dentistry ALLIED HEALTH
SCIENCES Nursing • Environmental Health • Medical Laboratory Technology • Psychology
CREATIVE ARTS & DESIGN Advertising Design • Creative Multimedia • Graphic Design
• Interior Design • Mass Communication • Music • Photography • Video & Animation
EDUCATION & SOCIAL SCIENCES Early Childhood Education • Montessori Pedagogy
HOTEL & TOURISM Hotel Management • Tourism Management POSTGRADUATE
STUDIES Doctor of Business Administration (DBA) • Master of Business Administration
(MBA) AMERICAN DEGREE PROGRAM Psychology • Communications • Finance •
Management • Marketing • Human Resource Management • Business Administration •
International Business FOUNDATION Science • Commerce • Information Technology •
A-Level PROFESSIONAL STUDIES ACCA • LCCI • ABE • CEH • CHFI

Please use BLOCK LETTERS to complete this form:

Programme:

Intake: Year:

www.segi.edu.my Campus: SEGi University College, Kota Damansara SEGi College Kuala Lumpur SEGi College Subang Jaya

Student Particulars
Department of International Office
Name of Applicant (as per Passport)
世纪大学学院 吉隆坡世纪学院 首邦再也世纪学院 槟城世纪学院 砂 拉 越 世 纪学院
SEGi University College SEGi College Kuala Lumpur SEGi College Subang Jaya SEGi College Penang SEGi College Sarawak
KP/JPS/DFT/US/B24 JPWP178 187620-W IPTS/SV.1031/42/98
B4P8001
No. 9, Jalan Teknologi, Wisma Greenhall,
Please affix Name in Chinese (if any)
Bangunan SEGi, 33-35, City Campus, Persiaran 211 Jalan Bukit Mata Kuching,
Taman Sains Selangor, 43, Green Hall, 10200 Penang 93100 Kuching, Sarawak
a passport
Jalan Hang Lekiu, Kewajipan, USJ 1,
Kota Damansara, PJU 5, 50100 Kuala Lumpur. 47600 UEP Subang Jaya
– sized
Tel: 04-263 3888 Tel: 082-252 566
47810 Petaling Jaya, Selangor Selangor D.E. photograph
Tel: 03-2070 2078 Fax: 04-262 2193 Fax: 082-231 355
Tel: 03-6145 1777 Tel: 03-8600 1888 Passport No.
Fax: 03-2034 2759 E-mail: infopg@segi.edu.my E-mail: infoswk@segi.edu.my
Fax: 03-6145 1666 Fax: 03-8600 1999
E-mail: infokl@segi.edu.my TOLL FREE: 1-300-88-7344
E-mail: infokd@segi.edu.my E-mail: infosj@segi.edu.my
TOLL FREE: 1800-88-8028
TOLL FREE: 1800-88-7344 TOLL FREE: 1800-88-8622 Passport Expiry Date (dd/mm/yy) Date of Birth (dd/mm/yy) Country of Birth

SEGi International Agent:

Nationality Religion Gender

Male Female

Email Marital Status

Single Married
 Admission Procedures for SEGi
1. Complete the
i) SEGi International Student Application Form &
INTERNATIONAL STUDENT APPLICATION FORM ii) University Form (If Applicable)
2. 1 photocopy of passport (all pages including blank pages) Passport must have at least 6 - 12 months validity.
Contact Address while studying in Malaysia *Please ensure that the front page and other information of the student is CLEARLY shown.

Address Tel 3. 6 recent passport size photographs (4cm x 5.5cm) with name and passport number written on the reverse sides.
4. Certified true copies of applicant’s academic qualification(s) in original language and English translated version.
5. Certified copy of evidence of your English language proficiency (if applicable)
Fax 6. Completed Medical report
7. To claim for exemption - provide Transcript and Syllabus / Course outline of your previous qualification(s).
8. Application processing fees of RM1800 (RM300 Application Fee + RM1500 Visa Application Fee), via bank draft or EFT, should be made payable to
relevant campus (details as given below).
Postcode City State Country Mobile Phone
9. Write-up of 150 words of work experience and curriculum vitae (if applicable) for MBA / DBA applicants
10. Certified true copies of academic certificate / transcript.

Permanent Home Address at country of origin (for correspondence purpose) Accommodation Required
Address Tel Please fill in Accommodation Booking Form and submit with necessary booking fees to confirm a place.
Subject to availability.

Yes No
Fax
Bank Details
SEGi University College, Kota Damansara
Beneficiary Name : SEGi University College (M) Sdn Bhd Banker’s Address : Damansara Utama (Uptown Branch) Selangor, Malaysia
Postcode City State Country Mobile Phone
Bank Name : OCBC Bank (Malaysia) Berhad Swift Code : OCBCMYKL
Beneficiary Bank Account Number : 707-105-9595 (OCBC Bank) Beneficiary Phone Number : 603-61452613 / 603-6145 1643

Parent/Guardian/Sponsor Particulars (in case of emergency) SEGi College Subang Jaya

Full name Parent / Guardian Beneficiary Name : SEGi College (Subang Jaya) Sdn Bhd Banker’s Address : OCBC (M) Bhd (Subang Jaya Branch)
Bank Name : OCBC Bank (M) Bhd Selangor, Malaysia
Subang Jaya Branch Swift Code : OCBCMYKL
Beneficiary Bank Account Number : 708-104-9797
Correspondence Address Tel
SEGi College Kuala Lumpur

Beneficiary Name : SEGi College (KL) Sdn Bhd Bank Address : (Hang Lekiu Branch) Kuala Lumpur, Malaysia
Fax Bank Name : Public Bank Berhad Swift Code : PBBEMYKLXXX
Beneficiary Bank Account Number : 308-586-9618

FOR OFFICE USE ONLY

Postcode City State Country Mobile Phone
Counselled by Date

Qualifications
School/Institution/University Qualification From To Remarks

Please send the Visa Approval Letter (VAL) to

Name of student / Agent Representative:
Address:
Work Experience (if any) Post Code:
Country: Tel: Email:
Company Position From To
Admission
Approved by Date

Full Offer Conditional Offer Reject

Remarks & Recommendations

Declaration
I declare that the information provided by me in connection with this application is true and correct. I undertake to inform SEGi College / SEGi University Bursary (Fees paid are Non-Refundable)
College immediately of any change in address, phone number and/or other information provided by me in this application.
I understand that SEGi College / SEGi University College reserves the right to vary or reverse any decision regarding admission or enrolment made on
Fees paid Amount Receipt No.
the basis of incorrect or incomplete information. I agree to be bound by the Terms and Conditions of the offer to study at SEGi College / SEGi University Application Cheque No.
College.
Security Deposit Cash
Processed by
Facility Charges Telegraphic Transfer
Tuition Credit Card Date
Signature of Applicant: Date: Others