Office use only

Student number Test date:

Registration Form English and Exams Services

Welcome to the British Council, Kuala Lumpur. Kindly complete this form and return it to us.
Selamat datang ke British Council, Kuala Lumpur. Sila lengkapkan borang ini dan kembalikan kepada kami.

YOUNG LEARNERS Standard _______ Form _______ International school Total score /50 Recommended level:

You must complete the form in English yourself in order to take a placement test. PERSONAL DETAILS
MAKLUMAT PERIBADI)

Title (Mr, Ms, etc):

(Gelaran)

Male

Female

Comments:

Last name / Surname (as on NRIC /passport):

(Nama akhir/keluarga (seperti di No Kad Pengenalan / No Pasport)

ADULTS / YOUNG ADULTS G: V: R: Overall:

Recommended Level

First names (as on NRIC / passport):

Nama awal (seperti di No Kad Pengenalan / No Pasport)

NRIC/Passport No:
(No Kad Pengenalan / No Pasport)

1. Write the level for full-time or part-time. Write both if student is unsure which they will study. 2. Circle an arrow to indicate if student may be placed one level higher, lower or no other level.

Full time

Part time

Bus Eng PI Bus Eng Int Bus Eng UI

Date of Birth:
(Tarikh Lahir)

date (DD)
(tarikh)

month (MM)
(bulan)

year (YYYY)
(tahun)

Nationality:
(Warganegara)

_____________

_____________

Address:
(Alamat)

L IELTS IELTS

City
(Bandar)

Postcode:
( Poskod)

Country:
(Negara)

Comments:

Tel No:
(No Telefon)

Name of advisor:
PLEASE ENSURE THIS FORM IS RETURNED TO THE RECEPTION COUNTER.

Mobile No:
(No Telefon Bimbit)

Email address:
( Alamat E-mel)
The United Kingdoms international organisation for educational opportunities and cultural relations. We are registered in England as a charity.

Please let us know about any special requirements you/your child has in terms of health, allergies, physical (e.g. hearing impaired) or special learning needs (e.g. dyslexia, ADD). (Sila maklumkan kami tentang sebarang keperluan khas yang anda/ anak
anda ada dari segi kesihatan, alahan, fizikal (contohnya kurang pendengaran) atau keperluan pembelajaran khas) ___________________________________________________________

The British Council Data Protection Notice / Notis Perlindungan Data British Council Under the terms of the United Kingdoms Data Protection Act, 1998, the British Council is required by law to manage any personal information you give to us about yourself or your child securely and only for the purposes we have specified. To maintain academic and educational records on our students To provide academic records for our students sponsors, where applicable To be able to cater for any special needs our students To maintain an accurate database on our students for communication purposes To maintain accurate financial records By signing this form, you agree to The British Councils collecting and processing this information for the purposes specified above, which may involve the transfer of your data to another British Council office. Di bawah syarat-syarat Akta Perlindungan Data United Kingdom, 1998, The British Council perlu menguruskan sebarang maklumat peribadi yang anda berikan mengenai diri anda atau anak anda dengan cara yang selamat dan hanya untuk tujuan yang kami nyatakan sahaja. Untuk menyimpan rekod akademik dan pendidikan para pelajar kami Untuk memberikan rekod akademik kepada penaja pelajar, bila perlu Untuk bersedia memenuhi sebarang keperluan khas para pelajar Untuk mengekalkan pengkalan data berkenaan para pelajar kami yang tepat bagi tujuan komunikasi Untuk menyimpan rekod kewangan yang tepat Dengan menandatangani borang ini, anda bersetuju bahawa The British Council boleh mengumpul dan memproses maklumat ini bagi tujuan-tujuan yang disenaraikan di atas, di mana ia mungkin melibatkan pemindahan data anda ke pejabat British Council yang lain. I have read and I understand the British Council Data Protection Notice. (Saya telah
membaca dan memahami Notis Perlindungan Data British Council.))

PARENT/ GUARDIAN DETAILS if student is below 18 (Maklumat Ibubapa/Penjaga jika

pelajar berumur bawah 18 tahun)

Full name:

_____________________________________________________

(Nama Penuh seperti di dalam kad pengenalan)

NRIC / Pasport:

__________________________________________________

(No Kad Pengenalan / No Passpot)

I hereby give my consent for the care and treatment of my child in the case of accident or medical emergency. (Saya mengizinkan anak saya menerima jagaan dan rawatan sekiranya
berlaku kemalangan atau kecemasan perubatan.) Please note that the British Council does not take liability for the outcome of any medical treatment given to your child by a qualified medical practitioner. (Dimaklumkan bahawa British Council tidak bertanggungjawab ke atas akibat rawatan perubatan yang diberi kepada anak kamu oleh seseorang ahli perubatan yang diiktiraf.)

Signature (Tandatangan): _____________________________________________

Stay up to date with The British Councils new events, exhibitions, products and services. If you do not wish to receive any of this information, please tick the relevant boxes. Sila tandakan di sini jika anda tidak berminat untuk mengikuti perkembangan terkini daripada British Council seperti akitiviti, pameran, produk and perkhidmatan .

Email

SMS

Newsletter

Signature (Tandatangan): _____________________________________________

Registration form Oct 2012