APPLICATION FOR ENROLMENT

Application for: Diploma in Marine Engineering (Engine Cadet)

A) PERSONAL PARTICULARS:

Name (in full): KEVIN ENTURAN ANAK ENCHIRONG

Address: S/L 4545 BANDAR BARU PERMYJAYA TUDAN,MIRI

Postcode 98100
Town / City: MIRI
State: SARAWAK
Telephone (Home): 085-654908 Gender: Male
Mobile Phone: 019-8563059

Date of Birth (dd/mm/yyyy): 20-Jun-1993 Age: 17

Citizenship: MALAYSIAN Height (cm): 172

Weight (kg): 60
BMI: 20.28

Place of Birth: SIBU NRIC: 930620-13-5733

Religion: Christian Ethnic / Race:Others

Email Address: genjiAtun93@gmail.com

B) ACADEMIC REQUIREMENTS:

SPM Exam Result

Year: 2010

Subject Level Obtained in SPM

1) Malay Language A+
2) English Language A
3) Mathematics A
4) Physics
5) Additional Mathematics E

C) QUESTIONS:
1) Are you a swimmer?
Answer: Yes

2) Are you wearing visual aids (spectacles or contact lens)?

Answer: No
If "Yes", please
No advise the degree of your visual aid : (must <200 or 6/9)

3) Are you colour blind?

Answer: No
4) Are you suffering from any illness that may hinder you from attending any course?
Answer: No

5) Extra Curricula Acitivities:

5.1) Uniform Body
Position / Rank

5.2) Non-Uniform Body

Position / Rank
 5.3) Sports REPRESENT STATE IN FOOTBALL
Representing

6) Hobbies:
Answer: FUTSAL

D) PARENTS / GUARDIAN INFORMATION:

Father / Guardian's Name ENCHIRONG AYUT

Occupation: LOGISTIC COORDINATOR

Telephone (Home): O85-654908

Mobile Phone: 019-8845953

E) EMERGENCY CONTACT DETAILS FOR NEXT OF KIN

Name: SEBIT BAYUM

Address:
S/L 4545 BANDAR BARU PERMYJAYA TUDAN MIRI

Telephone (Home): 085-6548908

Mobile Phone: 013-8074545

Relationship: MOTHER

F) OTHERS
1) If you are not successful to get a sponsorship, would you consider paying on your own for this programme?
Answer: Yes

2) Does your parent work for PETRONAS, MISC Berhad or its subsidiary?
Answer: Yes

If yes, please state :

Name ENCHIRONG AYUT
Relationship FATHER
PETRONAS/MISC/Subsidiary (if subsidiary, please state the name of the subsidiary)
Department MARINE DEPARTMENT
Designation

G) INSTRUCTIONS TO APPLICANTS
This form must be completed and submitted via email to (alam2011intake@alam.edu.my) before 1700hrs 9th
1) JANUARY 2011 and a printed copy is to be brought along on the interview day (if you are successful) together with
certified photocopies of the following documents:-
a) Identity Card
b) School Leaving Certificates
c) SPM exam result

2) Please bring along RM10 for processing fee and RM80 for administrative fee (Total RM90) Postal/Money Order payable to
"Malaysian Maritime Academy Sdn. Bhd.".

3) ONLY shortlisted candidates will be notified for an interview via email.

4) Successful candidates will be required to attend the Candidate Fitness Assessment (CFA) which will consist of 6 physical
tests. Only candidates who are successful in the CFA test will be offered a placement for the course.

H) DECLARATION

I confirm and certify that the information given above (Please select) Agree
are true. I also agree that ALAM has the right to reject
my application in the event that the particulars given
are found to be untrue.

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