HOSTEL APPLICATION Full Name as in MyKad/Passport * MyKad/Passport No. * Student ID No. * Date of Birth * Email * Programme Enrolled * Certificate in English LanguageCertificate in Business ManagementFoundation in BusinessDiploma in Business ManagementDiploma in FinanceDiploma in AccountingDiploma in International BusinessDiploma in MarketingDiploma in Mass CommunicationDiploma in Tourism ManagementDiploma in Information TechnologyDiploma in Information Technology (Digital Media) Gender * MaleFemale Semester Intake * Marital Status * SingleMarriedDivorcedWidowed Expected Date of Arrival * Race * Bumiputera ChineseIndianOthers Nationality * AfghanistanAlbaniaAlgeriaArgentinaAustraliaAustriaBangladeshBelgiumBoliviaBotswanaBrazilBulgariaCambodiaCameroonCanadaChileChinaColombia *Costa RicaCroatiaCubaCzech RepublicDenmarkDominican RepublicEcuadorEgyptEl SalvadorEnglandEstoniaEthiopiaFijiFinlandFranceGermanyGhanaGreeceGuatemalaHaitiHondurasHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKenyaKuwaitLaosLatviaLebanonLibyaLithuaniaMadagascarMalaysiaMaliMaltaMexicoMongoliaMoroccoMozambiqueNamibiaNepalNetherlandsNew ZealandNicaraguaNigeriaNorwayPakistanPanamaParaguayPeruPhilippinesPolandPortugalRomaniaRussiaSaudi ArabiaScotlandSenegalSerbiaSingaporeSlovakiaSouth AfricaSouth KoreaSpainSri LankaSudanSwedenSwitzerlandSyriaTaiwanTajikistanThailandTongaTunisiaTurkeyUkraineUnited Arab Emirates(The) United Kingdom(The) United StatesUruguayVenezuelaVietnamWalesZambiaZimbabwe Religion * MuslimBuddhistHinduChristianOthers Permanent Home Address 1 * Permanent Home Address 2 Postcode * Mobile Phone Number * Email * Name * Relationship * MotherFatherBrotherSisterGuardianFriend Mobile Phone Number * Email * Allergies Blood Type * ABABO Illness Tick if you are disabled State the nature of the disability Any medical condition which may be of concern other than stated above Accommodation subject to availability Room Type * Suite Room A (Ensuite) - RM950.00 / monthSuite Room B (Ensuite) - RM1,090.00 / monthSingle Room with Shared Bathroom - RM520.00 / monthDouble Room with Shared Bathroom - RM350.00 / monthTriple Room with Shared Bathroom - RM250.00 / month By submitting this form, you agree to the Kolej MDIS Malaysia privacy notice. Submit Step 1 of 7 - Personal Information 14% HiddenUnique IDFull Name(Required) First Student ID(Required) MyKad/Passport No.(Required) Date of Birth(Required) DD slash MM slash YYYY Gender(Required)Select oneMaleFemaleMarital Status(Required)Select oneSingleMarriedDivorcedWidowedRace(Required)Select oneMalayChineseIndianOthersReligion(Required)Select oneIslamBuddhismDaoismChristianityHinduismOthersNationality(Required)Select oneAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsMobile(Required)Email(Required) Permanent Home Address Line 1(Required) Permanent Home Address Line 2 Postcode(Required) Programme Name(Required)Select oneCertificate in English LanguageCertificate in Business ManagementFoundation in BusinessDiploma in Business ManagementDiploma in FinanceDiploma in AccountingDiploma in International BusinessDiploma in MarketingDiploma in Mass CommunicationDiploma in Tourism ManagementDiploma in Information TechnologyDiploma in Information Technology (Digital Media)Bachelor of Science (Honours) in Business Management 3+0 in Collaboration with Bangor University, UKBachelor of Science (Honours) in Marketing 3+0 in Collaboration with Bangor University, UKBachelor of Science (Honours) in Accounting and Finance 3+0 in Collaboration with Bangor University, UKBachelor of Science (Honours) in Banking and Finance 3+0 in Collaboration with Bangor University, UKIntakeMonth(Required)Select oneJanuaryFebruaryAprilJuneSeptemberYear(Required) Your Arrival Date(Required) DD slash MM slash YYYY Full Name(Required) Relationship(Required)Select oneMotherFatherBrotherSisterGuardianFriendMobile(Required)Email(Required) Allergies Blood TypeSelect oneABABOIllness If you are physically disabled, please state the nature of the disability. If not, please write 'NIL'. Any medical condition which may be of concern other than stated above, if not, please write 'NIL'. Passport Size Photo(Required) Drop files here or Select files Accepted file types: jpg, jpeg, png, pdf, Max. file size: 5 MB, Max. files: 1. Room Type(Required)Select oneSuite Room A (Ensuite)Suite Room B (Ensuite)Single Room with Shared BathroomDouble Room with Shared BathroomTriple Room with Shared BathroomConditions of Reservation: 1. All successful applicants are required to sign a Tenancy Agreement.2. Room deposit is equivalent to one month room rental.3. Room access card deposit is RM50.00.4. Payment of room rental and deposits will be paid to Finance Department upon signing the Tenancy Agreement. Please enter your full name here as an acceptance of the conditions.Name of Applicant(Required) CAPTCHA
