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Victoria International College

No 984, 986 & 988, Jalan Kampung Batu, Taman Batu off 5th Mile,Jalan Ipoh, 51200 Kuala Lumpur

Application Form For Admission As Student At Victoria International College For Foreign Applicants

(You can get this form from www.vicmy.com Xerox copy of this also may be used as application for admission into University.)

(CAPITAL LETTERS ONLY)

YOUR EDUCATIONAL BACKGROUND
Qualification

Secondary / Matriculation

Higher Secondary / Senior Secondary / Intermediate

Graduation / Degree / Diploma

Name of Examination
Name of University / Board
Year of Passing
Grade / Point / Percentage
FACULTY THAT YOU WISH TO APPLY FOR
S.No

1

2

3

4

Degree/Diploma/Certificate
Medium of Instruction( i.e.English)
Department For Course
LIST OF DOCUMENTS TO BE SEND WITH THE APPLICATION
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OTHER APPLICATIONS

Have you ever applied for any other Educational Institution in Ukraine? If yes, furnish the details

PERSONAL STATEMENT FOR CHOOSING OUR UNIVERSITY
SWORN STATEMENT

I confirm that to best of my knowledge and belief that all the information I have given on this form is true , complete and accurate . I have enclosed the required documents (certificates, supporting documents, etc.). I am aware that intentionally or negligently giving false information constitutes an administrative offence and may lead to exclusion from the admission procedures or – if discovered at letter date – to the cancellation of my admission or enrolment.

Place:
Date:
Name/Signature:
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