Undergraduate Taster Courses at

University of Nottingham Malaysia

Campus for Refugees and Asylum
Seekers
Please only complete this form if you want to take short courses
linked to undergraduate study at the University. Please read the
following instructions clearly; without all of the information, we
cannot process your application.
Please note that students on these taster courses attend the same
classes as our other students and therefore will need to operate at
the same academic level. You are asked to provide evidence of your
ability to do this in your application.

A) Please state clearly which undergraduate course you would like

to pursue. Go to our website to research the available courses and
their admissions criteria.
http://www.nottingham.edu.my/index.aspx

B) Please include a short statement of no more than 500 words

explaining why you wish to take this course. Remember that this
will be read by the Admissions Tutor for the course, so explain
your academic interests clearly. If you do not meet one of our
admissions criteria, explain why you consider your application to
be of merit nonetheless.

C) Please send the application and statement as a single word file.

Please provide scanned copies of certificates where possible. Send
a single email containing the application form, statements and
scanned certificates.

D) Please note that whilst fees will be waived for successful

applicants, there is no scholarship offering help with living costs or
transportation available at present.

E) Applications must be submitted by email by Monday, 31st July to

the UNHCR.

Note: We do not accept applications made directly to the

university.
1. PERSONAL DETAILS

First Name(s):

Family Name/Last Name: (This is the name under which your file will be
registered)

Passport Number / IC (Malaysian)/ UNHCR Number:

Title Male/Female Date of Nationality

Birth

Day Month Year

Correspondence Address:

E-Mail address: (Please write clearly) Home address: (If different from
correspondence address)

Home number: Mobile number:

2. QUALIFICATIONS AND GENERAL EDUCATIONAL BACKGROUND

Qualification Institution Year awarded

2.1 English Proficiency:

Results Date of Test Taken

IELTS

TOEFL

CAMBRIDGE First
Certificate

Others

Please attach your scanned test certificate with your application.

2.2 Referee: Please give details of a person whom we may contact

concerning your application.

Name of referee:

Address: Occupation:

E-mail:

Fax No:

Telephone No:

Relationship to applicant:
 2.3 Emergency Contact Details

Name of Emergency Contact Person:

Address: Occupation:

E-mail:

Fax No:

Telephone No:

Relationship to applicant:

SECTION 3: PERSONAL INFORMATION

1) Do you have a disability?

YES NO

If yes, please provide further details

______________________________________________________________________________

______________________________________________________________________________

2) Do you have health insurance? If no, you must take out health insurance as it is not
provided. YES NO

3) Have you had a health check? If no, you may be asked to undergo one before attending
courses on campus.
YES NO

I declare that the information supplied in this form is true to the best of my
knowledge and belief.

Signature:.

Date:..

*Please return your completed application form to: chongy@unhcr.org