REQUEST FOR REPLACEMENT OF AWARD CERTIFICATE/TRANSCRIPT/RESULT STATEMENT (A). APPICATION DETAILSFull Name : *Title : *Please selectMrMsMrsMissStudent ID : *Identity Card Number : *Email Address : *Contact Number : *Fax :Address : *(B). QUALIFICATIONFull Name on Certificate : *Intake : *Programme of Study : *Award Obtained : *Awarding Institution :(C). FEESPlease tick the appropriate box below : *Certificate with amounting RM250.00Academic Transcript with amounting RM100.00Result Statement with amounting RM20.00 per piece.Upload File : *Police ReportChoose FileNo file chosenDelete uploaded file(D). DECLARATIONDeclaration *I declare that my original certificate and/or academic transcript and/or result statement was LOST/DESTROYED/STOLEN/DAMAGED (POLICE REPORT ATTACHED) and hence I request for a replacement of the certificate and/or transcript and/or result statement. I hereby conform that he information provided on this application form is correct and true.Submit
