borang maklumat pelajar

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PERIBADI : - NO. MATRIK :- ___________________________ GELARAN :- CIK/ PUAN/ ENCIK/ DATO’/ DATUK/ DATIN/ HJ/ HAJJAH NAMA :- _____________________________________________________________ NO. K/P :- ________________________ JANTINA :- LELAKI / PEREMPUAN TARIKH LAHIR :- ____________________ NO.TEL RUMAH :- _____________________ NO TEL BIMBIT :- ______________________ EMAIL :- _____________________________ ALAMAT :- _________________________________________________________________ _ _________________________________________________________________ _ TARAF PERKAHWINAN :- BUJANG/ BERKAHWIN/ DUDA/ JANDA/ BALU AGAMA :-_______________________

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Page 1: Borang Maklumat Pelajar

PERIBADI : -

NO. MATRIK :- ___________________________

GELARAN :- CIK/ PUAN/ ENCIK/ DATO’/ DATUK/ DATIN/ HJ/ HAJJAH

NAMA :- _____________________________________________________________

NO. K/P :- ________________________

JANTINA :- LELAKI / PEREMPUAN

TARIKH LAHIR :- ____________________

NO.TEL RUMAH :- _____________________

NO TEL BIMBIT :- ______________________

EMAIL :- _____________________________

ALAMAT :- __________________________________________________________________

__________________________________________________________________

TARAF PERKAHWINAN :- BUJANG/ BERKAHWIN/ DUDA/ JANDA/ BALU

AGAMA :-_______________________

BANGSA :- _____________________

TEMPAT LAHIR :- __________________________

OKU :- BUKAN / IA (SILA NYATAKAN JIKA IA) _______________ _________________

Page 2: Borang Maklumat Pelajar

KELAYAKAN MASUK :- SPM / STPM / PROGRAM SIJIL PERGURUAN / PROGRAM DIPLOMA PERGURUAN.

PASANGAN

ALAMAT :-_________________________________________________________________

__________________________________________________________________

NO. TEL :- _______________________

PENDAPATAN :- _______________________

WARIS

NO. TEL;- _____________________

ALAMAT :- _________________________________________________________________

_________________________________________________________________

HUBUNGAN :- _____________________________

AKADEMIK

BIDANG AMBILAN :- ___________________________

NAMA INSTITUSI :- ____________________________________

TAHUN PENGANUGERAHAN :- ________________________

Page 3: Borang Maklumat Pelajar

TAHAP KELAYAKAN:- ____________________

NAMA KELAYAKAN:-________________________

PENGALAMAN

JAWATAN :- _____________________________

NAMA MAJIKAN :- ______________________________________

TARIKH MULA:- ________________________

TARIKH TAMAT :- ____________________

GAJI:- _________________

MAKLUMAT KEPAKARAN

NAMA BADAN :- ______________________________

NO. AHLI :- ____________________

TARIKH AHLI :- _________________________

GELARAN KEAHLIAN:- ________________________

Page 4: Borang Maklumat Pelajar

MAKLUMAT AKTIVITI

NAMA AKTIVITI :- __________________________________

JENIS PENGLIBATAN :- ______________________________

TAHUN AKTIVITI :- _________________________________

MAKLUMAT KESALAHAN

NO. RUJUKAN:- ___________________________

NAMA PEGAWAI:- ____________________________

TARIKH KESALAHAN :-_______________________________

JENIS KESALAHAN :- _________________________

HUKUMAN :- _____________________________

MAKLUMAT PENUKARAN INSTITUSI

NAMA INSTITUSI TERDAHULU :- ____________________________________________

KURSUS PENGAJIAN :- __________________________________

TARIKH TAMAT :- _______________________

SEBAB PERTUKARAN :- ______________________________________