ONLINE APPLICATION FORM

Please read the following ONLINE APPLICATION GUIDELINES clearly.

Step 1: Complete this Online Application Form & click on the "Submit" button at the bottom to send online.
Step 2: Please print TWO(2) copies of this completed form. Keep one for your personal reference.
Step 3: Send the other copy with all the documents listed in the "Checklist For Application" at the bottom of this form & application fees to IMPERIA INSITUTE OF TECHNOLOGY immediately.

Please take note that applicants for Degree programmes, you have to submit the Heriot Watt University Application Form(click here to download) and your resume(if applicable).

ALL the above documents should be sent to:

Marketing Department
Imperia Institute of Technology
Level 6, Kelana Brem Tower 2
Jalan Stadium (SS7/15)
47301 Kelana Jaya
Selangor

Note: Fields marked with asterick (*) are mandatory.

PROGRAMME
Programme Applied *
Intake *
Mode of Study *
Accommodation *
PERSONAL DETAILS
Name (as per NRIC/Passport) *
NRIC/Passport No. *
Date of Birth *
Place of Birth *
Sex *
Marital Status *
Race *
Religion
Citizenship *
Country of Origin
(for International applicants only)
CONTACT DETAILS
Permanent Address *
Correspondence Address
(if different)
Email Address *
Telephone No. (H/O)
Handphone No. *
Fax No.  
Name of Next of Kin *
Relationship *
Contact No. *
ACADEMIC BACKGROUND *
School/Institute/University
Qualification (if any)
Year Completed
EMPLOYMENT HISTORY (if applicable)
Employer
Position/Nature of Duties
From (Month/Year)
To (Month/Year)
CHECKLIST FOR APPLICATION
Checklist for Local Student (to be submitted with this Application Form)

1.

2.

3.

4.

5.

Online Application Fee RM20 (non-refundable) for all programmes**

Four (4) passport size coloured photographs (Name & Programme written at the back of the photographs)

Certified True Copy of all Transcripts / Certificate (e.g. SPM, STPM, Diploma and etc)

Photocopy of IC (Front & Back)

The following only applicable for degree students.

  • Heriot Watt University Application Form (to be completed & signed by students)
  • Resume -latest information & to be type (if applicable)
Checklist for International Student (to be submitted with this Application Form)

1.

2.

3.

4.

5.

Online Application Fee and Visa Processing Fee USD240 (non-refundable) for all programmes**

Eight (8) passport size coloured photographs (Name & Programme written at the back of the photographs)

Certified True Copy of all Transcripts / Certificate (e.g. O-Levels, A-Levels, Diploma and etc)

Photocopy of Passport (All pages)

The following only applicable for degree students.

  • Heriot Watt University Application Form (to be completed & signed by students)
  • Resume -latest information & to be type (if applicable)
** All payment via cheque or bank draf to be made to IMPERIA INSTITUTE OF TECHNOLOGY
(applicant has to write his/her name according to IC/Passport at the back of the cheque).
**

Applicant may also deposit directly or telegraphic transfer into IMPERIA's bank account. The details are as follows:
Bank Name: CIMB
Account Name: Imperia Institute of Technology
Account No: 0511-0001903-059
Switch Code: CIBBMYKL
Bank Address: PT 7464, Jalan BBN 1/1A, Putra Point 1, 71800 Bandar Baru Nilai, Negeri Sembilan
(applicant has to post or fax the bank-in slip to the college (Fax No. :03-7492 6788)
DECLARATION

I hereby declare that to the best of my knowledge all information and documents submitted or made by me to the college, whether in relation to any course of study or otherwise(the "information"), is true, accurate and complete.

I understand that the college reserves the right at anytime to withdraw a place which has been offered to me due to incomplete and/or incorrect information.

I agree to be bound by the Terms and Conditions of the offer to study at Imperia Institute of Technology.

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