APEL(A) Application Form
Please enter your details in the application form below:
Full Name (as in IC/Passport) *
Your answer
Nationality *
NRIC / Pasport no. *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Gender *
Applicant's Correspondence address *
Your answer
Permanent/ Home/ Parent's Address (please provide if different from above) *
Your answer
Contact Number
Home *
Your answer
Office *
Your answer
Fax *
Your answer
Mobile *
Your answer
Email *
Your answer
Highest qualification *
Your answer
Do you intend to pursue your tertiary study in Universiti Tun Hussein Onn Malaysia *
Field of intended study *
Level of intended study
Note:
If you have any questions on this or you would like to discuss the matter then please email or call us:

Tel: 07-4537953
Fax: 07-4536051
email: apel@uthm.edu.my
Web: https://apel.uthm.edu.my/
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.