APPLICATION FORM   

Kindly fill up the form to apply as a GEMS participant. You are advised to read the application criteria requirements here. Only successful applicants will be contacted via telephone and email.

Name:
IC No.:	- -
Home Address:		Correspondence Address:
Address 1:		Address 1:
Address 2:		Address 2:
City.:		City.:
Postal Code:		Postal Code:
State.:	- Please select - Johor Kedah Kelantan Kuala Lumpur Melaka Negeri Sembilan Pahang Perak Perlis Pulau Pinang Sabah Sarawak Selangor Terengganu Labuan	State.:	- Please select - Johor Kedah Kelantan Kuala Lumpur Melaka Negeri Sembilan Pahang Perak Perlis Pulau Pinang Sabah Sarawak Selangor Terengganu Labuan
Mobile No.:	-
House No.:	-
Email Address:
Gender:	Male Female
Type of University:	- Please select - Public Private
University:	- Please select - Universiti Malaya Universiti Sains Malaysia Universiti Kebangsaan Malaysia Universiti Putra Malaysia Universiti Teknologi Malaysia Universiti Teknologi MARA Universiti Utara Malaysia Universiti Malaysia Sarawak Universiti Malaysia Sabah Universiti Pendidikan Sultan Idris Universiti Sains Islam Malaysia Universiti Malaysia Terengganu Universiti Tun Hussein Onn Malaysia Universiti Teknikal Malaysia Melaka Universiti Malaysia Pahang Universiti Malaysia Perlis Universiti Darul Iman Malaysia Universiti Malaysia Kelantan Universiti Pertahanan Nasional Malaysia Universiti Islam Antarabangsa Malaysia - Please select - Universiti AIMST Kolej Universiti Insaniah Asia e University Asia Pacific University College of Technology and Innovation HELP University College International Centre for Education in Islamic Finance Universiti Perubatan Antarabangsa Kolej Universiti Teknologi Antarabangsa Twintech Kolej Universiti Metropolitan Kuala Lumpur Universiti Terbuka Malaysia Universiti Tunku Abdul Rahman Universiti UCSI Universiti Kuala Lumpur Kolej Perubatan Melaka Manipal Kolej Universiti INTI Kolej Universiti Nilai Kolej Universiti Linton Seminari Theoloji Malaysia Kolej Perubatan Pulau Pinang Universiti Terbuka Wawasan Universiti Teknologi Petronas Curtin University of Technology Swinburne University of Technology Al-Madinah International University Binary University College of Management and Entrepreneurship Kolej Universiti Sains Perubatan Cyberjaya Universiti Industri Selangor Kolej Universiti Infrastruktur Kuala Lumpur University of Nottingham Universiti Teknologi Kreatif Limkokwing Universiti Sains dan Teknologi Malaysia Management and Science University Monash University Multimedia University Kolej Universiti SEGi Kolej Universiti Islam Antarabangsa Selangor Sunway University College Kolej Universiti Taylor's Universiti Tenaga Nasional Universiti Tun Abdul Razak Kolej Universiti TATI Others If others, Please select the type of university first.
Degree:
Field of Studies:	- Please select - Social Science Information Technology Pure Science Engineering (View Categories)
Graduation Date:	Month: - Please select - 1 2 3 4 5 6 7 8 9 10 11 12 Year: - Please select - 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
CGPA:
English Proficiency Level:	- Please select - 10 9 8 7 6 5 4 3 2 1 (0=Poor - 10=Excellent)
MUET:	- Please select - Band 1 Band 2 Band 3 Band 4 Band 5 Band 6 None
Preferred Region:	Central Eastern Northern Southern Sabah Sarawak (View Regions)
Marital Status:	- Please select - Single Married
Availability:	Immediate Upon Serving - Please select - 1 month 2 months 3 months 4 months 5 months
Current Employment:	Fresh Graduate Unemployed (more than 6 months after graduation)
Willing to undergo on job training at various locations in Malaysia:	Yes No

Required fields are designated with asterisk (*)