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Universiti Tunku Abdul Rahman

Form Title: APPLICATION FORM


Form Number: FM-DACE-003

Rev No. : 1

Effective Date: 01/06/2016

Page No: 1 of 3

Ref.
No
(For Office Use)

UNIVERSITI TUNKU ABDUL RAHMAN


Wholly owned by UTAR Education Foundation (Co. No. 578227 M)

Student Application Form October 2016 Intake


(Bachelor Honours Degree Programmes)
Section A: To be completed by applicant
* Have you previously applied to UTAR?
If Yes, please state your UTAR ID No.:

Yes

No
e.g.12UKB03456

Choose 5 programmes you would like to study and list them in order of preference.
Note: UTAR reserves the right to offer the programme available or alternative programme within the relevant study discipline.

PREFERRED PROGRAMME NAME


1.
2.
3.
4.
5.

I. PERSONAL INFORMATION
1. Name (as in NRIC): ___________________________________________________________
2. NRIC No:

3. Nationality: __________________

4. Date of Birth: _____________________________

5. Gender:

Male

Female

(Day/Month/Year))

6. Address: ____________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
Postcode: ___________________________

State: ________________________________

7. Contact No: (H)______________________

(H/P): _______________________________

8. E-Mail: _____________________________________________________________________
_____________________________________________________________________
9. Race:

Malay

Chinese

Indian

Others _________________________
(Please specify)

10. Religion:

Islam

Buddhism

Hinduism

Christianity

Others ___________
___________
(Please specify)

11. Do you suffer from any physical disability or illness? If so, please specify the nature of these
conditions. Otherwise, state None.
____________________________________________________________________________
1

Universiti Tunku Abdul Rahman


Form Title: APPLICATION FORM
Form Number: FM-DACE-003

Rev No. : 1

Effective Date: 01/06/2016

Page No: 2 of 3

II.
II. PARTICULARS OF PARENT/GUARDIAN
1. Name of Parent/Guardian: _______________________________________________________
2. Relationship: ___________________________ (H/P): ________________________________
________________________________
III.
III. DECLARATION
DECLARATION BY APPLICANT
PERSONAL DATA PROTECTION STATEMENT
(https://www.utar.edu.my/PersonalDataProtectionStatementAdmission.jsp)
https://www.utar.edu.my/PersonalDataProtectionStatementAdmission.jsp)

I understand and agree to the University using and processing my personal data as contained in this
form. I have read, understood and agreed to the Personal Data Protection Statement of the
University (click to read PDP statement). You may access and UPDATE your personal data by
writing to us at admission@utar.edu.my

I declare that the information provided by me in connection with this application is true and correct.
I understand that Universiti Tunku Abdul Rahman reserves the right to withdraw the offer of
admission or ask me to leave the University at any time if such information is found to be false or
incorrect.

___________________________
Name of Applicant

_____________________
Signature of Applicant

____________
Date

Section B: For Office Use


Date Received:

Name of Staff-in-charge:

Complete and Processed:

Incomplete:


A non-refundable processing fee of


RM60.00

Certified true copy of SPM/STPM/


A-Level/UEC/SAM/CPU/TARUC/LL
results

Certified true copy of MUET result

Certified true copy of School Leaving


Certificate and Identity Card

Others
_____________________________
Date:

Remarks:
2

Universiti Tunku Abdul Rahman


Form Title: APPLICATION FORM
Form Number: FM-DACE-003

Rev No. : 1

Effective Date: 01/06/2016

Page No: 3 of 3

IV. APPLICATION CHECKLIST


Completed application form must be submitted together with the following documents:
Self-addressed envelope measuring 7 X 10 affixed with RM1.00 stamp;
Self-addressed envelope measuring 3.5 X 6 affixed with RM0.80 stamp;
(All documents must be certified by School Principal/Justice of Peace/State Assemblyman/Member
of Parliament)
Certified true copy of SPM/Other equivalent results;
Certified true copy of STPM/A-Level/UEC/SAM/CPU/Other equivalent results;
Certified true copies of School Leaving Certificate and Identity Card;
Certified true copy of MUET result;
Certified true copy of certificate/ academic transcript/ syllabus/ programme structure/
complete Diploma/ Bachelor or equivalent results;
A non-refundable processing fee of RM60.00 in money order/postal order/bankdraft made
payable to Universiti Tunku Abdul Rahman.
Rahman (Please note that personal cheque/cash is

NOT accepted);
Programme Commences on Monday, 17th.
17th. October 2016
Please indicate UTAR OCTOBER 2016 INTAKE on the top left corner of the envelope
and send the application form to:
Division of Admissions and Credit Evaluation
Universiti Tunku Abdul Rahman
Jalan Sungai Long,
Bandar Sungai Long,Cheras
43000 Kajang.Selangor Darul Ehsan

OR

Jalan Universiti,
Bandar Barat, 31900 Kampar.
Perak Darul Ridzuan

PROGRAMME CODES
Institute of Chinese Studies (Kampar Campus)
Bachelor of Arts (Hons) Chinese Studies (UBCH)
Faculty of Arts and Social Science (Kampar Campus)
Bachelor of Communication (Hons) Journalism (UBJR)
Bachelor of Communication (Hons) Public Relations (UBPR)
Bachelor of Communication (Hons) Advertising (UBAV)
Bachelor of Social Science (Hons) Psychology (UBPY)
Bachelor of Arts (Hons) English Language (UBEL)
Bachelor of Arts (Hons) English Education (UBED)
Faculty of Creative Industries (Sungai Long Campus)
Bachelor of Communication (Hons) Broadcasting (UBBC)
Bachelor of Arts (Hons) Graphic Design and Multimedia (UBGD)
Bachelor of Corporate Communication (Hons) (UBCC)
Bachelor of Media and Creative Studies (Hons) (UBMC)
Bachelor of Arts (Hons) Game Design (UBGS)
Bachelor of Arts (Hons) Journalism in Chinese Media (UBJC)
Bachelor of Early Childhood Education (Hons) (UBEA)
Bachelor of Arts (Hons) Digital Animation (UBDA)
Bachelor of Science (Hons) Game Development (UBGV)
Faculty of Business and Finance (Kampar Campus)
Bachelor of Commerce (Hons) Accounting (UBAC)
Bachelor of Business Administration (Hons) (UBBA)
Bachelor of Business Administration (Hons) Banking and Finance (UBBF)
Bachelor of Business Administration (Hons) Entrepreneurship (UBEN)
Bachelor of Marketing (Hons) (UBMK)
Bachelor of Economics (Hons) Financial Economics (UBFE)
Bachelor of Finance (Hons) (UBFN)
Faculty of Accountancy and Management (Sungai Long Campus)
Bachelor of Economics (Hons) Global Economics (UBGE)
Bachelor of International Business (Hons) (UBIN)
Bachelor of Accounting (Hons) (UBAT)
Bachelor of Building and Property Management (Hons) (UBBP)
Faculty of Information and Communication Technology (Kampar Campus)
Bachelor of Computer Science (Hons) (UBCS)
Bachelor of Information Systems (Hons) Information Systems Engineering (UBIA)
Bachelor of Information Systems (Hons) Business Information Systems (UBIB)
Bachelor of Information Technology (Hons) Computer Engineering (UBCT)
Bachelor of Information Technology (Hons) Communications and Networking (UBCN)

PROGRAMME CODES
Faculty of Engineering and Green Technology (Kampar Campus)
Bachelor of Engineering (Hons) Electronic Engineering (UBEE)
Bachelor of Science (Hons) Construction Management (UBCM)
Bachelor of Engineering (Hons) Environmental Engineering (UBEV)
Bachelor of Engineering (Hons) Petrochemical Engineering (UBPE)
Bachelor of Engineering (Hons) Industrial Engineering (UBIE)
Faculty of Science (Kampar Campus)
Bachelor of Science (Hons) Biotechnology (UBBT)
Bachelor of Science (Hons) Chemistry (UBCE)
Bachelor of Science (Hons) Biochemistry (UBBE)
Bachelor of Science (Hons) Biomedical Science (UBBM)
Bachelor of Science (Hons) Statistical Computing and Operations Research (UBSC)
Bachelor of Science (Hons) Microbiology (UBMB)
Bachelor of Science (Hons) Logistics and International Shipping (UBLI)
Bachelor of Science (Hons) Agricultural Science (UBAG)
Bachelor of Science (Hons) Food Science (UBFD)
Lee Kong Chian Faculty of Engineering and Science (Sungai Long Campus)
Bachelor of Science (Hons) Applied Mathematics with Computing (UBAM)
Bachelor of Science (Hons) Actuarial Science (UBAS)
Bachelor of Science (Hons) Quantity Surveying (UBQS)
Bachelor of Engineering (Hons) Electrical and Electronic Engineering (UB3E)
Bachelor of Engineering (Hons) Mechanical Engineering (UBME)
Bachelor of Engineering (Hons) Materials and Manufacturing Engineering (UBMM)
Bachelor of Engineering (Hons) Civil Engineering (UBCI)
Bachelor of Engineering (Hons) Electronic and Communications Engineering (UBEC)
Bachelor of Science (Hons) Physics (UBPH)
Bachelor of Engineering (Hons) Biomedical Engineering (UBBI)
Bachelor of Engineering (Hons) Chemical Engineering (UBCL)
Bachelor of Engineering (Hons) Mechatronics Engineering (UBMH)
Bachelor of Science (Hons) Financial Mathematics (UBFM)
Bachelor of Science (Hons) Software Engineering (UBSE)
Faculty of Medicine and Health Sciences (Sungai Long Campus)
Bachelor of Chinese Medicine (Hons) (UBCD)
Bachelor of Nursing (Hons) (UBNS)
Bachelor of Physiotherapy (Hons) (UBPS)

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