Online Student Registration Form - Sekolah Bina Insan-MSU Foundation
Registration Information
Application For School *
For Intake Year *
For Level Form/Year *
Preferred Session* Preferred Session Will Be Finalized By Management
Previous School
Student Information
Student Name*
Nationality
IC No/Passport* (No Space and Dash '-')
Birth Cert. No
Birth Place* Others
Birth Date*
Gender/Race/Religion*
Tel. Mobile* (Parent) (No Space and Dash '-')
Email (Parent) Eg. mel@yahoo.com
Tel. Home
Address (Line 1)*
Address (Line 2)
City*
Postcode* Others
Illness/Alergic

 Others (Specify) :  
Untitled Document
Guardian / Father Information
Name*
IC No / Passport*
Relation*
Occupation
Salary* (RM)
Education
Employer
Address
Tel. Mobile (No Space and Dash '-')
Tel. Home
Tel. Office Fax:
Email Eg. mel@yahoo.com
Mother Information
Name*
IC No / Passport*
Relation*
Occupation House Wife (Klik)
Salary* (RM)
Education
Employer
Address
Tel. Mobile (No Space and Dash '-')
Tel. Home
Tel. Office Fax :
Email Eg. mel@yahoo.com
Family Information
  Name School/College/Job Birth Year
1.
2.
3.
4.
5.
6.
7.
8.
For Emergency Contact (Beside Parent)
 Name*
 Relation*
 Tel. Mobile* (No Space and Dash '-')
 Tel. Home
 Tel. Office
 Fax
 Email Eg. mel@yahoo.com
Others Information
How do you know about us
Untitled Document
G. MAKLUMAT ACADEMIC
1. MAKLUMAT PEPERIKSAAN UPSR
(Sila tandakan subjek yang berkenaan sahaja)

UPSR

NAMA SEKOLAH*
TAHUN PEPERIKSAAN*
- BAHASA MALAYSIA PEMAHAMAN
- BAHASA MALAYSIA PENULISAN
- BAHASA INGGERIS PEMAHAMAN
- BAHASA INGGERIS PENULISAN
- SAINS
- MATEMATIK
- PEKA
- FARDU AIN
2. PEPERIKSAAN LAIN (Jika ada)
Nama Sekolah
Tahun
Nama Peperiksaan
  Mata Pelajaran Gred/Keputusan
1
2
3
4
5
6
7
8
9
10
3. MAKLUMAT KOKURIKULUM
  Sukan/Kelab/Persatuan Jawatan Tahap Sekolah/Daerah/Negeri/Negara
1
2
3
4
5
4. PENGUASAAN AL-QURAN
Kelancaran Membaca Quran Baik   Sederhana   Lemah
Kemahiran Membaca Jawi Baik   Sederhana   Lemah
Kemahiran Menulis Jawi Baik   Sederhana   Lemah
Telah Khatam Quran Ya   Tidak.
Jika TIDAK, juzuk ke berapakah sekarang?
Pernah Hafaz Quran Ya   Tidak.
Jika YA, Brapa juzukkah yang telah dihafal?

 

The management of the school has the right to refuse acceptance of the child if deemed necessary. In the event of any medical emergency, the school is hereby authorized to seek medical attention from the nearest available and qualified practitioner or hospital for the students. The school and its staff will not be responsible for any medical treatment administered to the students or for any medical charges incurred. If this information was not made known to the management of the school prior to the acceptance, the management of Sekolah Bina Insan reserves the right to revoke the acceptance of the child as a student of Sekolah Bina Insan. The school also has the right to terminate the student who are not fit in Sekolah Bina Insan environment and discipline cases based on recommendation by Head of Schools and Discipline Teacher.


Enrollment Declaration & Acceptance

I, Father/Mother/Guardian of the above child, confirm that I have read and understood the contents of the page. I shall abide by the terms above. I, hereby understood and agreed that all information given is correct. Sekolah Bina Insan has the rights to reject the application without prior notice.