FM-AA/EU-03

* For Office Use Application:

ACADEMIC TRANSCRIPT
APPLICATION FORM
INSTRUCTIONS 1. 2. Student is required to read IMPORTANT GUIDELINES carefully. Please fill up this form completely. Partial Transcript Replacement of Full Transcript (Graduated Student Only)

(Please tick ) APPLICATION NAME (Capital Letter) MATRIC NO PROGRAMME EMAIL (Please tick ) Collection by :

CONTACT NO Hand On behalf Name ID/ Passport No Post ( Address)

Date of application : Student's Signature

____ / ____ / ____ Date

____ / ____ am/pm Time

A
Please tick : Financial Outstanding

STUDENT ACCOUNTS MANAGEMENT UNIT

Yes No Amount :

Please tick Partial Transcript Full Transcript

Charges ( RM ) 5.00 25.00

Receipt No.

Signature & Stamp

____ / ____ / ____ Date

Rev. 3: April 10

FM-AA/EU-03

B
Date Received from Student Date of Collection ( by student )

ACADEMIC ADMINISTRATION DEPARTMENT

____ / ____ / ____ ____ / ____ / ____

IMPORTANT GUIDELINES Payment must be made to Student Accounts Management Unit. Please note on the following charges: Partial Transcript Replacement of Transcript RM5.00 RM25.00

Completed form must be submitted to Center Student Services Counter or Regional Center Coordinator. Please note on the following schedule: Time of Submission Before 11.30 am After 11.30 am Time of Collection 3.00 pm (on the same working day) 9.00 am (on the next following working day) Venue of Collection Center Student Services Counter Center Student Services Counter

Student who requests through post/fax will have to give three(3) working days excluding application day for processing

Rev. 3: April 10

FM-AA/EU-03

EMIC TRANSCRIPT

PLICATION FORM

am/pm

ACCOUNTS MANAGEMENT UNIT

Rev. 3: April 10

FM-AA/EU-03

ADMINISTRATION DEPARTMENT

Rev. 3: April 10