Course Interested
Name of Country

A. Personal Information
Name (as in NRIC)
NRIC No.
Date of Birth
Gender malefemale
Contact Number
Email
Address

B. Academic Qualification
Academic Qualifications (Examination results of SPM/ GCE "O" Level)
Actual ResultForecast/Trial Year
Subject Grade Subject Grade

Academic Qualifications (Examination results of STPM/ GCE "A" Level/Others)
Actual ResultForecast/Trial Year
Subject Grade Subject Grade
Other Qualifications
Name Of Institution
Level of Education
Name of Awards
CGPA
Grades
Year of Completion

C. Particulars of Parent/Guardian
Name Of Parents / Guardian
Address Of Parents / Guardian
Relationship
Occupation
Contact No. (Home)
Contact No. (HP)

D. Declaration by Applicants
I declare that the above information provided by me in connection with this application is true and correct. I understand that Eagle Eye Network Holdings Sdn Bhd reserves the right to withdraw the offer of admission at any time if such information is found to be false or incorrect.

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