International Student Application Form

No. 1, Persiaran Bukit Utama, 47800 Petaling Jaya,
Selangor Darul Ehsan, Malaysia.
Tel:+603-7735 2088 Hotline:+6016-3018 166 / +6016-3028 166

DKU031(B) JPT/BPP(D)1000-701/589

No. 1, Persiaran Bukit Utama, 47800 Petaling Jaya, Selangor Darul Ehsan, Malaysia.
Tel: +603-7735 2088
Hotline:+6016-3018 166 / +6016-3028 166


1. Complete and sign the application form.
2. Enclose certified true copy of each relevant certificate and transcript:
a) High or Secondary School
b) Pre-University or equivalent
c) Certificate / Diploma / Bachelor or equivalent
d) School Leaving Certificate / Testimonial
3. Enclose a copy of your valid passport biodata page.
4. email your completed application form and supporting documents to
1. If you are waiting for your official examination results, please submit a copy of your school’s forecast result or trial examination result.
2. Please translate the certificates and transcripts into English if applicable.
3. Eight (8) recent passport size coloured photographs.
4. The application must be accompanied by a non-refundable and non-transferable application fee.
5. All payments by Bank Telegraphic Transfer (TT) / Online Banking must be made in favor of ‘First City Corporation Sdn Bhd’.
For Office Use Only
Student No: Offer:Unconditional
Checked by: 
Programme Code: Conditional
Date : 
Intake: Agent Name: 
Personal Particulars
(As stated in your Passport)
Passport Number

*only insert numbers

Passport Expiry Date
Date of Birth
E-mail Address
Mobile Phone
House Phone
Marital Status
Name of Parent / Guardian
Occupation of Parent / Guardian
Permanent Address(if different from Correspondence Address)
Parent/ Guardian Mobile PhoneParent/Guardian House Phone
Parent/Guardian E-mail Address
Programme Particulars
Programme Applied For
Intake / Year
Foundation: Jan, May, Sep
Diploma: Jan, Jun, Oct
Bachelor's Degree: Jan, Jun, Oct
Postgraduate: Jan, May, Sep
Intensive English Programme: Jan, May, Sep
Academic Qualifications (Please tick ✓)
O-Levels A-LevelsFoundationYear taken
DiplomaDegreeHome Country QualificationYear taken
IELTSTOEFLScoreYear taken
Name of School / College / University AttendedYear
Employment Particulars(if Applicable)
Tel No
Position Held
Health Declaration
Do you have any disability(ies) or long term medical condition?NoYes
If yes, please state the type of disability and attach all relevant document(s).
Privacy Statement
Your personal information collected in this Application Form or otherwise provided in support of your application (“Personal Data”) is processed, retained and used by First City University College in accordance with the Malaysian Personal Data Protection Act 2010 (PDPA). Your Personal Data may be collected from or disclosed to relevant bodies including your parents/guardians/sponsors, government agencies, etc. for the verification of your grades, qualifications and/or experience, and/or as otherwise required of First City University College by applicable laws or relevant authorities. First City University College may also retain and continue to process your Personal Data after your completion of the programme enrolled for, or otherwise upon you ceasing to be a student of First City University College, for archiving purposes, First City University College’s alumni events and activities and/or to maintain record of your grades qualifications and/or experience as may be required by First City University College and/or meet requests by other institutions with whom you enroll for other programmes hereafter.
All documents that you provide to First City University College become the property of First City University College and will not be returned to you. You have the right to access or update your Personal Data, or make inquiries or submit any concerns thereto, by contacting the Registry Office at
I hereby declare that the information in this Application Form, or provided in support of my application, is correct and complete. I acknowledge that the provision of incorrect information or the withholding of relevant information relating to my application, including academic transcript(s), may invalidate my application, and that First City University College may withdraw an offer or cancel my acceptance of First City University College’s Offer in consequence thereof. Should First City University College determine that I have submitted a false document, I consent to First City University College disclosing this information to other relevant tertiary institutions/authorities without any liability whatsoever.

I further confirm and consent to the use by First City University College, without charge, my personal information including photographs, images or recordings of me in any publicity and/or promotional exercise of First City University College, including the publishing of examination results, the award of a prize or scholarship, and any achievement, academic or otherwise.

I understand that First City University College shall be deemed to have notified me in writing if any mail is posted to the most recent mailing address that I have provided in writing to the University College.

I also agree to abide by the policies, rules and regulations of the respective Faculties/Centres of First City University College at all times.

I have read and understood the Payment and Fee Refund Policy and the Privacy Statement and agree and accept them fully.

Declaration by Parent/Guardian
I hereby agree to promptly pay all fees, charges and security deposits due as stipulated by First City University College. I also understand and agree that if I default in paying any of these, First City University College has the right to bar my child/ ward from attending classes, and impose penalties up to and including deregistration. I have also read and understood the Payment and Fees Refund Policy and agree to the terms as stated. I hereby apply for admission of my child/ward to First City University College as a student and I undertake to pay all tuition fees and charges until completion of the programme of study applied for.

Name of Parent/Guardian
Passport Number of Parent / Guardian
Documentations upload required:
1. Academic Transcripts & Certificates:* (Multiple files is allowed)
2. Passport Details Page-1 file:*
3.Portfolio (Artwork) / Bank-in Slip (Optional) :