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2024 年度华文独中师资培育专案计划贷学金申请表
提出申请前，请确保符合相关条件才填写此申请表。
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* Indicates required question
中文姓名（全名）Student's Chinese Name：
*
Your answer
英文姓名（全名）Student's English Name（as per IC）：
*
请全采用大写字母 In Capital Letters
Your answer
性别 Gender：
*
女
男
年龄 Age：
*
Your answer
身份证号码 NRIC. No,：
*
例：xxxxxx-xx-xxxx
Your answer
联络号码（手机）H/P Contact No.：
*
例：012-000 0123
Your answer
联络号码（住家）Home Contact No. ：
例：03-8736 2337
Your answer
电邮地址 Email Address：
*
Your answer
住家地址 Home Address：
*
门牌，街道，花园，邮政编码，城市，州。例：No.5, Jalan Bukit 10, Taman Bukit, 43000 Kajang, Selangor.
Your answer
银行资料 Bank Detail：
供贷学金汇款用途，所以必须是申请者本身之户口。
银行名称 Bank Name：
Your answer
银行户口号码 Bank Account No.：
Your answer
银行户口名字 Bank Account Name：
若是跟父母联名户口，请填写完整名字。
Your answer
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This form was created inside of United Chinese School Committees’ Association of Malaysia (Dong Zong).
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