alam application form 2011 v5 (3)

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  • 7/28/2019 ALAM Application Form 2011 v5 (3)

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    Application for:

    A) PERSONAL PARTICULARS:

    Address:

    Postcode

    Town / City:

    State:

    Gender:

    Age:

    Height (cm):

    Weight (kg):

    BMI: #DIV/0!

    Place of Birth: NRIC:

    Religion: Ethnic / Race:

    Email Address:

    B) ACADEMIC REQUIREMENTS:

    SPM Exam Result

    Year:

    1) Malay Language

    2) English Language

    3) Mathematics

    4) Physics

    5) Additional Mathematics

    C) QUESTIONS:

    1) Are you a swimmer?

    Answer:

    2) Are you wearing visual aids (spectacles or contact lens)?

    Answer:

    If "Yes", please advise the degree of your visual aid : (must

  • 7/28/2019 ALAM Application Form 2011 v5 (3)

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    D) PARENTS / GUARDIAN INFORMATION:

    E) EMERGENCY CONTACT DETAILS FOR NEXT OF KIN

    Address:

    F) OTHERS

    1) If you are not successful to get a sponsorship, would you consider paying on your own for this programme?

    Answer:

    2) Does your parent work for PETRONAS, MISC Berhad or its subsidiary?

    Answer:

    If yes, please state :

    G) INSTRUCTIONS TO APPLICANTS

    1)

    a) Identity Card

    b) School Leaving Certificates

    c) SPM exam result

    2)

    3) ONLY shortlisted candidates will be notified for an interview via email.

    4)

    H) DECLARATION

    (Please select)

    V5

    Telephone (Home):

    Occupation:

    Father / Guardian's Name

    Name:

    Mobile Phone:

    I confirm and certify that the information given above are true.

    I also agree that ALAM has the right to reject my application in

    the event that the particulars given are found to be untrue.

    Telephone (Home):

    Mobile Phone:

    Relationship:

    This form must be completed and submitted via email to ([email protected]) before 1700hrs 4th APRIL 2011 and a

    printed copy is to be brought along on the interview day (if you are successful) together with certified photocopies of the following

    Name

    PETRONAS/MISC/Subsidiary (if subsidiary, please state the name of the subsidiary)

    Relationship

    Department

    Please bring along RM10 for processing fee and RM80 for administrative fee (Total RM90) Postal/Money Order payable to "Malaysian

    Maritime Academy Sdn. Bhd.".

    Designation

    Successful candidates will be required to attend the Candidate Fitness Assessment (CFA) which will consist of 6 physical tests. Only

    candidates who are successful in the CFA test will be offered a placement for the course.