1. Use UPPERCASE to complete this form. 1. of …. Use UPPERCASE to complete this form. ... true...
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1 1. Use UPPERCASE to complete this form. 2. Attach certified true copies of academic transcript/results and other relevant documents. 3. Ensure all information given are correct. 4. Completed form to be sent to: Yayasan Khazanah, Level 33, Tower 2, Petronas Twin Towers, Kuala Lumpur City Centre, 50088 Kuala Lumpur, Malaysia. Telephone: +603 20340000 Fax: +603 20340004 Choice of Discipline: 1. Please indicate Choice of Discipline of Study (Rank according to preference) *Refer to List Attached by University) Choice of Discipline: 2. 1. Full Name 2. Birth Certificate No. 3. National ID No. 4. Passport Number 5. Place of Birth 6. Date of Birth 7. Gender Female Male 8. Religion 9. Marital Status 10. Permanent Home Address Postcode State 11. Tel. No. (Residence) 12. Tel. No.(Mobile) 13. Email Address 14. No. of siblings 15. No. of working siblings Affix Six (6) of Your Passport Sized Photo Here
Transcript of 1. Use UPPERCASE to complete this form. 1. of …. Use UPPERCASE to complete this form. ... true...
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1. Use UPPERCASE to complete this form.
2. Attach certified true copies of academic transcript/results and other relevant documents.
3. Ensure all information given are correct.
4. Completed form to be sent to: Yayasan Khazanah, Level 33, Tower 2, Petronas Twin Towers, Kuala Lumpur City Centre,
50088 Kuala Lumpur, Malaysia. Telephone: +603 20340000 Fax: +603 20340004
Choice of Discipline:
1.
Please indicate Choice
of Discipline of Study
(Rank according to
preference)
*Refer to List Attached
by University)
Choice of Discipline:
2.
1. Full Name
2. Birth Certificate No. 3. National ID No.
4. Passport Number
5. Place of Birth
6. Date of Birth 7. Gender Female Male
8. Religion
9. Marital Status
10. Permanent Home
Address
Postcode State
11. Tel. No. (Residence)
12. Tel. No.(Mobile)
13. Email Address
14. No. of siblings 15. No. of working
siblings
Affix Six (6) of
Your Passport Sized
Photo Here
2
School Name Month/Year
No. Name of English Examination Method (Written /
Computer / Internet) Grade Points
Professional Body :
State : Country :
Name Of Professional :
Year From : To :
Part Completed
All Part
Institution / University :
State : Country :
Discipline :
Year From : To :
CGPA/Grade : Points/Class :
Institution / University :
State : Country :
Discipline : CGPA/Grade
Year From : To :
3
School Name State/Town
From Year To Year
No. Subject Grade Points / Marks
1
2
3
4
5
6
7
8
9
10
11
12
Total Mark – Division:
1.
2.
3.
1.
Please provide brief description about the society/club
2.
Please provide brief description about the society/club
3.
Please provide brief description about the society/club
4.
Please provide brief description about the society/club
1.
2.
3.
4.
4
1.
2.
3.
4.
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I HEREBY DECLARE THAT THE PARTICULARS PROVIDED IN THIS FORM ARE TRUE IN EVERY RESPECT.
I UNDERSTAND THAT IF ANY OF THESE PARTICULARS GIVEN BY ME ARE FOUND TO BE UNTRUE,
MY APPLICATION WILL AUTOMATICALLY BE DISQUALIFIED.
A signed personal statement of no more than 1,000 words that includes a description of the intended area of study and describes how
this will benefit Yunus Centre and Bangladesh in general. The statement should also outline the candidate’s reasons for wanting to study
in Malaysia, and summarise the personal qualities that would make the candidate a worthy recipient of the Khazanah Asia Scholarship.
Format:
Font: Arial 11pt
Line Spacing : 1.5 lines
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