HIGHLANDS INTERNATIONAL STUDENT APPLICATION FORM

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HIGHLANDS INTERNATIONAL CAMBRIDGE A LEVELS 10 KM, Genting Highlands, 69000 Genting Highlands, Pahang Darul Makmur, Malaysia. Tel: 03-6100 1688 Fax: 03-6100 3688 E-mail: truealevels@gmail.com AFFIX RECENT PASSPORT SIZE PHOTO HERE STUDENT APPLICATION FORM Applicants must meet the entry requirement for Cambridge A level program prior to the submission of this form based on SPM forecast result, or equivalent. Please complete all sections in BLOCK LETTERS (BLUE/BLACK) ink only. Please ensure that all the required sections are completed and all supporting documents are attached as mentioned in each section and send it to the address given above. SECTION A : COMBINATION OF SUBJECTS / CHOOSE MINIMUM 3 AND MAXIMUM OF 4 SUBJECTS Mathematics Chemistry Biology Physics Further Mathematics Economics Accounting Sociology Business Studies SECTION B : ACCOMMODATION Minimum 3 months compulsory stay at HIBS Required Not Required SECTION C : STUDENT INFORMATION First Name(as) as stated in IC/Passport: Surname/Family Name as stated in IC/Passport: Male Female (Tick where applicable) IC (Only Msian).: Passport No (Foreign student only) : Issue Date : Expire Date : Correspondence/Permanent Address (P.O. Box address is not acceptable for International Applicants): City : State : Country : Post Code : Home Telephone No. (Please include all international codes): Mobile Phone No : For International applicants only Malaysian Immigration Pass held : Malaysian PR Social Visit Student Dependent Diplomatic MM2H Work Permit Other (please soecify) : None Immigration Pass expiry date (dd/mm/yy) : For Applicants from the People s Republic of China only Please advice which Malaysian Consulate you wish to obtain your single entry visa into Malaysia : Shanghai Beijing Guangzhou

SECTION D : PARENTS INFORMATION Name of Parent/Guardian : Relationship : Occupation : Parent/Guardian Address (if different from above) : City : State : Country : Post Code : Home Telephone No. (Please include all international codes) : Mobile Phone No. : SECTION E : STUDENTS ACADEMIC QUALIFICATIONS If space given is insufficient, please include an attachment. Academic Qualifications (Include last school attended and examinations taken) Start date End date Institution name and location Qualification obtained Attach certified true copies of your school and public examination results. English language proficiency Please complete the table below and enclose a copy of your English language qualification. English Qualification (e.g. IELTS, TOEFL, MUET, SPM, 119) Year obtained score SECTION F : EXTRA-CURRICULAR ACTIVITIES Games / Societies Position Held Level (School, State, National, International etc) Year (yyy to yyy) SECTION G : MEDICAL HISTORY OF STUDENT Do you have any existing illness? YES NO (Tick where applicable) * If YES, state name, nature of illness and treatment you are currently receiving....... (if possible, please attach certified copies of student s medical reports) Blood group :... Allergies :...

Name of family physician ( or attending Doctor/Clinic/Hospital) : Address : City : State : Country : Post Code : Telephone No. (Please include all international codes): Fax No.: SECTION H : EMERGENCIES Name of Person to contact in an emergency : Relationship with student : IC / Passport No : Address (if different from above) : City : State : Country : Post Code : Telephone No. (Please include all international codes) : Fax No. : SECTION I : OTHER INFORMATIONS Will your course be self-financed or sponsored? If sponsored, please provide details of your sponsorship Self : or Organisation / Government sponsor :... Is there any other information about you that you would like to furnish us with that would enhance your profile?......... Where did you learn about Highlands International Boarding School at Genting Highlands? Advertisement Agent Personal recommendation Internet University brochure Other... SECTION J : HIBS RULES & REGULATION FOR ALL STUDENTS 1. HIBS POLICY OVER SUBJECTS REGISTRATION Any subject changes made are allowed within 20 working days from the date of commencement of course (CAL). Enrolment and cancellation of the registered subject after the stipulated period is subject to the approval from the Director of Studies. 2. ATTENDANCES AND RESULTS It is mandatory to maintain the following regulations by Ministry of Education Malaysia (MOE) / HIBS : To attend all compulsory subjects stipulated by MOE. To attend all lectures, tutorials, practical, weekly exams and other classes as required by the program. To maintain 80% of class attendance for each subject per semester, failing which, you will be barred from the final examinations. To attend all compulsory special extra classes if your weekly exam marks are below satisfactory. 3. ATTIRE Descent formal / casual wears.

4. YEARLY CLIMATE CHART In Malaysia, we do not have distinct seasons but the hot months are during June, July, August and rains during the month of December, January and February. In Genting Highlands where the school is located we have a very pleasant climate where we experience spring temperatures whole year around. 5. BOOKS & LEARNING MATERIALS All books and learning materials will be paid by the students. 6. STUDENTS ROOM All essential furnishing are available. Students room are furnished with cot, pillow, mattress and study table with shelves and a cupboard. 7. PANTRY Only Kettles and Fridge are available in the pantry on every floor for student s use. The school discourages cooking in the pantry for safety reasons. Please note that HIBS are culturally sensitive in relation to food. We therefore disallow Beef, Pork and non-halal food within the school premises. 8. MEDICATION All medications must be surrendered to the Matron and detail medical history of the student must be disclosed to the schools authorized Medical Assistant / Matron. 9. MUSICAL INSTRUMENT There is an Electric Piano in block A and an upright Piano in Block B available for students use and practice. Students may bring their own instruments e.g. Guitar, Harmonica to play in the Music Room. 10. BARRED ITEMS This list is for general reference only. If there are any further inquires, please refer to the House Master / House Mistress for a copy of the Rules and Regulations for the residents in the Halls of the Residence. Computer games, jewellery and luxury items. Electrical immersion heaters, irons, electric kettles and other electrical appliances All items that can cause harm or endanger the development of a healthy self Chewing gum is strictly forbidden (junk food and instant noodles are discouraged) Mobile phones, laptops, computers brought in must be declared. Usage of the items shall be decided by the House Master as a privilege and not as a right. In the line with our emphasis on simplicity we advise that clothing should not be very expensive as the claim for the laundry contractor cannot exceed RM25.00. Students are not encourged to keep money in their possession more than the recommended amount. Money above recommended amount, should be handed over to House Master for safety purpose. INTERNATIONAL STUDENT S RULES & REGULATIONS 1. Students visa Application. Your acceptance to HIBS is subject to the approval of your student visa application by HIBS & the Immigration Department Malaysia. HIBS will not be held responsible for the time taken to process your application and/or rejection of your application by the relevant authorities. 2. Validity of Passport & Pass. You must hold a valid passport and student pass for the entire duration of your stay in Malaysia. You are responsible for the validity of any kind of immigration pass / and must abide by the rules and regulations imposed by HIBS and the Immigration Department Malaysia. 3 Report to HIBS. You are required to report to the Office of HIBS within 3 days of your arrival, to pay all outstanding fees, to proceed for medical examination and submission of passport for endorsement of student pass. 4 Payment of Fee. You are required to report to the Finance and Admissions department to pay the program fee and to present the original certificate (s) and supporting documents within 7 days after the commencement date of the course (CAL) 5. Payment of Insurance. Medical Examination, Student Pass & Personal Bond. You shall bear all charges related to your insurance / medical examination / student pass / personal bond or penalty charged by EMGS & the Immigration Department Malaysia. 6 No Employment. You are not allowed to engage in any kind of work or occupation in Malaysia while holding a student pass unless you have obtained the approval from the Immigration Department. 7 Extension of Student Pass. You are required to pay RM 2,000 Advance Fee before applying to extend your student pass. All application for student pass must be submitted to the Office 2 months before the expiry date of your student pass. 8. Withdrawal. You must inform HIBS in writing if you wish to withdraw from the institution and report to the Office for cancellation of your student pass. HIBS reserves the right to forfeit the caution fee and inform the Immigration Department to cancel your student pass if you fail to do a proper cancellation before leaving the country. 9. Inactive. If you have registered but fail to attend any classes 1 month after the commencement date without informing HIBS officially, you will be classified as withdrawn. All fees and security deposit will be forfeited and HIBS will inform immigration to cancel your student pass.

10. Code of Conduct. You are required to abide by the HIBS Code of Conduct, Code of Discipline and HIBS Student Handbook. Students must abide and be bound by ALL applicable laws in Malaysia. This is regardless of whether the student has acquainted themselves to such regulations. HIBS reserves the right at any time to elect new rules and regulations, to amend existing rules and regulations which shall take effect retrospectively and students are further advised to refer to the students Handbook regurlarly for such amendments. SECTION K : STUDENT S DECLARATION I have read and fully understand the terms and conditions and effects there of listed in Section H. I hereby specifically confirm my agreement. I further undertake to abide by all such obligations and/ or comply with all terms and conditions set out in Section H on my part to be performed with all payments as agreed. I agree that any offer of placement is conditional on the accuracy of the information provided by me and upon my meeting the minimium pre-requite results to enter into such program....... Signature of Applicant Signature of Parents / Guardian Date :... /... /... SECTION L : CHECKLIST OF ESSENTIAL THINGS TO BRING 1. Blanket - 1 piece, 2 pillowcases and 2 bed sheets (for single bed). 2. Toiletries - Toothbrush, toothpaste, bathing soap, tissue paper, shampoo, small mirrior etc. 3. Casual Wears: i. BOYS - Short and long sleeve shirts and plain trousers. ii. GIRLS - Dresses, blouses, skirts and other suitable evening wear. Students are required to be neatly and smartly dressed when they are in the school s premises. 4. Footwear - School shoes - 1 pair (Boys & Girls will wear flat bottomed normal black leather shoes which are not fanciful). Sport shoes - 1 pair for indoor games (they should be of plain shoes and not coloured to prevent markings on the floorings) and 1 pair for outdoor games. Slippers - 1 pair for bathroom use. 5. Umbrella / raincoat - 1 piece. Plastic pail - 1 medium size, laundry powder - 1 small packet. 6. Swimming costumes / trunk and swimming cap. 7. Mug and spoon, water- bottle and clothes hanger. 8. One medium size padlock with duplicate keys. SECTION M : LETTER OF CONSENT (HIBS) / PARENTS / GUARDIAN SAMPLE SIGNATURE I, the undersigned, give my consent for my daughter / son / ward... IC / Passport No... to study at Highlands International Cambridge A Level at Highlands International Boarding School with effect from...until......... Signature of Parent / Guardian Signature of Parent / Guardian Name :... Date :... /... /...

SECTION N : PAYMENT I enclose herewith a sum of RM500 cash / cheque (Non-Refundable) towards the Registration Fee for this application. Fees are payable by cash, cheque or bank draft. Cheques or Draft should be crossed and made payable to : HIGHLANDS INTERNATIONAL BORDING SCHOOL. Date :... /... /... Cheque / Receipt No :... SECTION O : ACCOPANYING DOCUMENTS 1. Completely filled Application Form 2. Document checklist for Malaysian applicants i. 2 copies of IC ii. 6 passport size photos iii. 1 certified true copy of ALL academic certificates & transcripts iv. Certified forecast results / SPM / IGCSE / CBSE / Other Equivalent 3. Document checklist for International applicants i. 3 copies of passport (all pages, detail page (s) in colour, 2 years validity) ii. 6 passport photos (blue background) iii. 3 certified true copies of ALL academic certificates & transcripts iv. Original NOC / Eligibility Letter v. Payment of EMGS fee and registration fee 4. Parent / Guardian consent letter 5. 1 copy of both parents identity card / passport 6. 2 copies of passport size photos (both parents) 7. Photocopy of student s birth certificate 8. 1 copy of student s school leaving certificate 9. Enclose with a sum of RM500 cash / cheque (Non-Refundable) towards the Registration Fee. Application Form and all documentation should be sent to the folllowing address: A Levels Admission Officer 10 KM, Genting Highlands, 69000 Genting Highlands, Pahang Darul Makmur, Malaysia. Tel : 03-6100 1688, Fax : 03-6100 3688 Eimail : truealevel@gmail.com SECTION P : FOR OFFICE USE ONLY Student I.D. : Category of Acceptance : Accepted : Conditional Acceptance : Rejected : Entry date : Academic requirements for Conditional Acceptance Other Conditions :... Remarks :... Check by :... Signature :... Recruited by : Friend to friend Introducer s name :... Others... Agent Company name & stamp : Admission Process by : Signature:...