Tuition and Special Program Registration Form - IIUM SCHOOLS SDN BHD
Registration Information
Application For School * :
Tuition Programme * :
Session * :
Student Name* :
IC No / Passport* :
:
Current School :
Citizen :
Birth Date* :
Gender/Race/Religion* :
Tel. Mobile* (Parent) :
Email (Parent) :
Tel. Home :
Address (Line 1)* :
Address (Line 2) :
City* :
Postcode* : Others
How do you know about us :
Untitled Document
Guardian / Father Information / Mother Information
Name*
IC No / Passport*
Relation*
Occupation
Tel. Mobile
Tel. Home / Office
Email
For Emergency Contact (Beside Parent)
 Name* :
 Relation* :
 Tel. Mobile* :
 Tel. Home / Office :

We confirm that to the best of our knowledge the information given are correct and complete. We have read the terms and conditions and hereby understand our obligations and accept the terms and conditions as stated herein. By clicking on 'I accept' below you are agreeing to the Terms and Conditions (read).