DETAILS

AWARD
Swinburne University of Technology
Application for Foundation Certificate
DETAILS OPTIONS

R E M E M B E RFIL
: L BEFORE PRINTING
COLLECTION

Please submit this application accompanied with a photocopy of IC or Passport

STUDENT

Tick (√) at the appropriate boxes:

Foundation
StudentID No./Serial No.: Date of Birth:
Are you an International Student? Yes No
Title: Dr Mr Ms Miss Mrs Others – please specify:
Fami ly name:
Given Name:
Pronunciation (if request):
Mai l ni g Address:

Phone No.: Emai l Address:

Course Code: ExpectedCompletion Date:

Full title o f Course:
(e.g. Foundation of Business)

Select one of the fol lowing tw o options

Tick (√) the appropriate :
I w illclaim my certificate from Swinburne Sarawak
Please mai l my certificate to mailing address
A W ARD /REMIT TA NCE COST:
• Malaysian Address RM100.00
• Outside Malaysia – East Asia, U SA , U K & Austral ia RM200.00
• Outside Malaysia – Europe, Middle East & India RM250.00

Swinburne University of Technology – Application for Foundation Certificate Version 2, May 2010
SUBMITTING APPLICATIONS
Swinburne University of Technology
Application for Foundation Certificate
R E M E M B E RFIL
: L BEFORE PRINTING

Record your address below if Certificate is to be mailed overseas.

What date wil l you leave Kuching?
OVERSEAS ADDRESS

Address:

Phone:
Email Address:

P A YME N TMETHODS:
PAYMENT OPTIONS

♦ Payment made by cash can be made at the Finance Counter, SWINBURNE SARAWA K CAMPUS
♦ Payment made by cheque should be crossed and made payable to “SWINBURNE SARA WAK SD N . BH D.”
♦ Appl icants can also make payment via our banker, R H B BA N K &Account Number: 211016-00065829
♦ Please extend payment advice and bank-in sl ip to us if cheque/cash is banked with our banker
Credit cardholders can use the payment options below
Payment by CREDIT CA R Dat Finance Counter Only:
CREDIT CAR D DETA ILS (A lldetai ls below must be completed)
Credit Card Type: MasterCard Visa
Credit Card Number:
Card Expiry Date: Month Year
Name on Card:
Cardholder’s Signature: Date:

A llappl ications can be submitted directly to Cl ient Services (CS) Building G Level 1. Appl ications also can be mai led or faxed to:
POSTAL AD DRESS
StudentInformation Centre (1st Floor) If you have any enquiries, please contact the Student Information Centre:

StudentOperations Telephone: (+6)082-416353

Swinburne University of Technology (Sarawak Fax no.: (+6)082-260819

Campus) Website: www.swinburne.edu.my/corporate/registrar/graduation
Jalan Simpang Tiga Email: sic@ sw inbu rn e.edu.m y
93350Kuching, Sarawak

Swinburne University of Technology – Application for Foundation Certificate Version 2, May 2010
 SIGNATURE
Swinburne University of Technology
Application for Foundation Certificate
R E M E M B E RFIL
: L BEFORE PRINTING

IMPORTA N TPOINTS TO N OTE B EFORE SU BMIT TIN G THIS FORM

♦ A lldebts with the university must have been cleared
♦ Appl icants have enrol led for the award they are applying for
♦ A llappl ications fo r exemptions have been lodged with and processed by your school
♦ Appl ication form to be accompanied with a photocopyof IC o r Passport
Please sign below as acknowledgement that you have read and understood all the requirements of this form. Uponreceipt of yo ur award
appl ication form, an acknowledgement letter w illbe sent to you.
Signature of appl icant: Date:

For Office use Only

Debt Checked Name, Address & Phone Checked Enrolment Checked LOC Request
Initials:

Privacy Statement
Swinburne University of Technology (Sarawak Campus) collects uses and destroys personal information in accordance with our Privacy
policy.

Swinburne University of Technology – Application for Foundation Certificate Version 2, May 2010