Universiti Malaysia Sabah

APPLICATION FORM FOR UNDERGRADUATE STUDIES

[Program Details]

1st Choice[Faculty]

1st Choice[Program]

2nd Choice[Faculty]

2nd Choice[Program]

3rd Choice[Faculty]

3rd Choice[Program]

**UMS RESERVES THE RIGHTS TO OFFER A DIFFERENT PROGRAM THAT SUITED ACCORDING TO THE CANDIDATE’S ACADEMIC BACKGROUND.

[Personal Information]

Name

Passport Number

Gender

Date of Birth

Ethnic(eg Japanese)

Nationality(eg Japan)

Address

City

Country

Post code

Hand phone number(eg +81-90-0000-0000)

House phone number(eg +81-3-0000-0000)

Fax number(eg +81-90-0000-0000)

Email address

Emergency contact name

Emergency contact number(eg +81-90-0000-0000)

Emergency contact email address

[Family Background]

Father

Name[Father]

Passport number[Father]

Address[Father]

City[Father]

Post code[Father]

Office phone number[Father](eg +81-3-0000-0000)

House phone number[Father](eg +81-3-0000-0000)

Hand phone number[Father](eg +81-90-0000-0000)

Mother

Name[Mother]

Passport number[Mother]

Address[Mother]

City[Mother]

Post code[Mother]

Office phone number[Mother](eg +81-3-0000-0000)

House phone number[Mother](eg +81-3-0000-0000)

Hand phone number[Mother](eg +81-90-0000-0000)

Brother/Sister

Name[Brother/Sister]

Relationship

Passport number[Brother/Sister]

Address[Brother/Sister]

City[Brother/Sister]

Post code[Brother/Sister]

Office phone number[Brother/Sister](eg +81-3-0000-0000)

House phone number[Brother/Sister](eg +81-3-0000-0000)

Hand phone number[Brother/Sister](eg +81-90-0000-0000)

Brother/Sister

Name[Brother/Sister]

Relationship

Passport number[Brother/Sister]

Address[Brother/Sister]

City[Brother/Sister]

Post code[Brother/Sister]

Office phone number[Brother/Sister](eg +81-3-0000-0000)

House phone number[Brother/Sister](eg +81-3-0000-0000)

Hand phone number[Brother/Sister](eg +81-90-0000-0000)

Grand father/Grand mother

Name[Grand father/Grand mother]

Relationship

Passport number[Grand father/Grand mother]

Address[Grand father/Grand mother]

City[Grand father/Grand mother]

Post code[Grand father/Grand mother]

Office phone number[Grand father/Grand mother](eg +81-3-0000-0000)

House phone number[Grand father/Grand mother](eg +81-3-0000-0000)

Hand phone number[Grand father/Grand mother](eg +81-90-0000-0000)

Grand father/Grand mother

Name[Grand father/Grand mother]

Relationship

Passport number[Grand father/Grand mother]

Address[Grand father/Grand mother]

City[Grand father/Grand mother]

Post code[Grand father/Grand mother]

Office phone number[Grand father/Grand mother](eg +81-3-0000-0000)

House phone number[Grand father/Grand mother](eg +81-3-0000-0000)

Hand phone number[Grand father/Grand mother](eg +81-90-0000-0000)

Other mambers

Other members information(Name/Address/City/Post code/Office・House・Hand Phone numbers)

[Language Proficiency]

IELTS overall score

Month taken

Year taken

[Academic background]

Level

High School

Bachelor Degree

Associate Degree

Others

For answered "Others", what level do you have?

High school/University/College name

Degree name(eg Certificate of high school graduation)

Graduation year

Result

[Financial support]

Category

Gurantor's name

Guarantor's passport/individual number

Guarantor's occupancy

Guarantor's monthly income(Ringgit/RM1=JPY25)

Guarantor's address

City

Post code

Country

Guarantor's house phone number(eg +81-3-0000-0000)

Guarantor's hand phone number(+81-90-0000-0000)

Guarantor's fax number(+81-3-0000-0000)

[Declaration]

I understand that withholding information requested may make me ineligible for admission to the University Malaysia Sabah and I also would like to certify that the information that I have provided on this application and in all other application materials is complete, accurate and true to the best of my knowledge and if admitted, I agree to abide by the rules and regulations of the University. I understand that misrepresentation of application information is a sufficient ground for cancelling admission or registration.

I understand

プライバシーポリシーが適用されます。

メモ: * は入力必須項目です