Page 49 - index

ALUMNI
ADVANCEMENT OFFICE
// personal details forms
INSTITUTIONAL ADVANCEMENT

CENTRE

BORANG MAKLUMAT PERIBADI / PERSONAL DETAILS FORM
MAKLUMAT PERIBADI / PERSONAL INFORMATION
Nama yang didaftarkan semasa Ijazah Dasar / Pasca
Ijazah
Name registered as undergraduate / postgraduate
Gelaran dan anugerah diterima (Cth: Tan Sri, Dato’, Dr.)
Please include title/honorifics
No Kad Pengenalan Lama No Kad Pengenalan Baru
Old I/C No New I/C No

Alamat Tetap
Permanent Address

Alamat surat menyurat
(jika berlainan dengan
atas)
Postal Address (if different
from above)
Alamat Email
Email address
Facebook (Jika ada)
Facebook (if applicable)
Nombor telefon (rumah) Telefon bimbit
Telephone number (Home) Mobile number
MAKLUMAT PEKERJAAN /WORK INFORMATION optional
Nama Syarikat Jawatan
Company name Post
Alamat Syarikat
Company Address
No Telefon Pejabat No Fax Pejabat
Office phone number Office fax number
MAKLUMAT PENDIDIKAN / EDUCATION
Program yang diikuti Tahun tamat pengajian
*Kelayakan yang diterima dari UM
Program Enrolled Year of Graduation
Diploma
Diploma

Sarjana Muda
Bachelor

Sarjana
Master

Doktor Falsafah
PHD
* Sila tandakan yang berkenaan / please tick which applicable

Note
Alumni Database verified via I/C number.
Data in the database are private and confidential, to be accessed only by staff of the Institutional Advancement Centre (IAC),
UM for official purposes.

49