AGMI

AGMI Home > Student Enrollment Form

Student Enrollment Form

Course Enroll

	Choice of Course:
		If Others, please specify
	Mode of Study:
	Mode of Payment:

Personal Particulars
*please fill up all fields in this section

Full Name: (As in NRIC/Passport)*

NRIC/FIN no:*

Passport no.:*

Passport Issue & Expiry date: (Permit holder only)*

Date of Birth: (dd/mm/yyyy)*

Age:*

Place of Birth:*

Nationality:*

Gender:*

Race:*

Religion:*

Marital Status:*

Occupation:*

Address:*

Postal Code:*

Home Tel:*

Mobile:*

Email:*

Parent/Guardian (for applicant below 21 years old)

Full Name: (As in NRIC/Passport)	NRIC/FIN no:
Passport no.: (For Non-resident)	Occupation:
Nationality:	Gender:
Marital Status:	Relationship:
Address: Postal Code:	Home Tel:
Mobile:	Email:

I hereby enroll for the course as indicated in this form. I declare that all information given is true and correct. I also agree to abide by the decision of the School as to my eligibility for the applied course. If accepted, I agree to abide by all terms and conditions governing this application.

* All Students’ particulars obtained are solely for the purposes of completing course submission. We will seek consent from Students should their particulars be used for purposes other than marketing and billing purposes.