1. Personal Information
I am a:
Malaysian Student Non-Malaysian Student
First Name
Last Name / Surname
Date of Birth Day Month year
  Identity Card No
( Eg: 870110065298 )
Male Female 
Mobile No. - -
Country code - Area code - Phone Number
  2. Permanent Address
City / Town
3. Academic Qualification
Institution/University Grade
Institution/University Grade
  4. English Qualification
  5. Work Experience (Applicable to postgraduate applicant)
  6. Programme Preferred 1  
Mode Study  
Programme Level/Study
  7. Programme Preferred 2  
Programme Level/Study
Faculty / School
Intake Month
  8. Programme Preferred 3  
Programme Level/Study
Faculty / School
Intake Month
  9. Declaration & Agreement by Applicant  
I decare that the information provided by me in connection with the application is true and correct. I undertake to inform SEGi University immediately of any changes in address, phone number and any other information provided by me in this application. I understand that SEGi University reserves the right to vary or reverse any decision regarding admission or enrolment made on the basis of incorrect or imcomplete information. I agree to be bound by the Terms and Conditions of the offer to student at SEGi University .  
  10. Declaration by Parent / Guardian / Sponsor / (Applicable of applicants who are 21 and below)
Telephone No.
E-mail Address
City / Town
11. Verification
I allow SEGi University Group to contact me (your details will not be given to any third party)
I agree to SEGi University Group's Terms & Conditions and Privacy Policy