ONLINE APPLICATION FORM
KOLEJ ITA, SIBU
Please complete the following form with relevant information.
Course : 1st Choice *
Please choose the program you prefer
Course : 2nd Choice *
If you have any second choice
Intake *
Please check intake month
Required
Accommodation *
Do you need accommodation ?
Required
PERSONAL DETAILS
Full Name *
Please give your full name as on NRIC or passport
Your answer
IC No./Passport No. *
Please provide identity card number or travelling document number
Your answer
Date of Birth *
Please provide your date of birth
MM
/
DD
/
YYYY
Gender *
Required
Student Phone (Mobile) *
Please provide student contact number. Example-60123456789
Your answer
Father Phone (Mobile)
Please provide father contact number. Example-60123456789
Your answer
Mother Phone (Mobile)
Please provide mother contact number. Example-60123456789
Your answer
Email
Please provide you email
Your answer
Address *
Your answer
Post Code *
Your answer
City *
Your answer
State *
Your answer
SPM EXAM RESULT
Year SPM *
Please select the year.
Bahasa Melayu *
This is a required question
Your answer
Bahasa Inggeris *
This is a required question
Your answer
Mathematics
Your answer
Science
Your answer
Sejarah
Your answer
Biology
Your answer
Chemistry
Your answer
Physics
Your answer
Additional Mathematics
Your answer
Others results
Example, Perdangangan, Grade B
Your answer
Your answer
Your answer
Your answer
Your answer
Your answer
QUICK SURVEY
How do your know about ITA ?
You may choose more than one option.
More details
Your answer
* Please fill in your result for qualification validation.
* Please double check your details before send to us.
* If you do not receive our call within 3 working days, Please call us at 084-218515, 012-8879003 or 014-6249366
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