2025/2026 IJMB APPLICATION FORM

FORM ID: C2U-LZK-MD7N

PERSONAL DETAILS

BIODATA

NIN NUMBER^*

Passport^*

Lastname^*

Firstname^*

Middlename^*

Gender^*

Date of Birth^*

Address Line 1^*

Address Line 2

City

Phone Number

Email

State of Origin

Name of Sponsor^*

Address of Sponsors^*

Sponsor's Phone Number^*

Sponsor's Email^*

Relationship with Sponsor^*

PROGRAMME DETAILS

ACADEMIC AND INSTITUTIONAL DETAILS

First Choice of Study

O-LEVEL RESULT

O-LEVEL RESULT

Exam/Type

Exam Number

Exam Centre

Exam Year

SUBJECT GRADE

IJMB SUBJECT COMBINATIONS

IJMB SUBJECT COMBINATIONS

IJMB SUBJECT COMBINATIONS