Application Form

Date of Birth (required)

Gender
MaleFemale

Your Email (required)

Phone (required)

Emergency Contact Name (required)

Emergency Contact Phone (required)

Intake Dates

Health Declaration
The purpose of this Medical Questionnaire is to find out if you should be examined by your doctor before participating in a Full Time course program.
Are you currently taking prescription medication? (with the exception of birth control or anti-malarial)
YesNo

Have you ever had or do you currently have...
Frequent or severe attacks of hayfever or allergy?Diabetes?High blood pressure or take medicine to control blood pressureNo

Address

C-2-1 & C-2-2 TTDI Plaza,
Jalan Wan Kadir 3,
Taman Tun Dr. Ismail,
60000 Kuala Lumpur

Phone

+603 7732 9468

MRT

Less than a minute walking distance from TTDI MRT