APPLICATION FORM
UNI-BRIDGE DIPLOMA PROGRAM IN ASSOCIATION WITH
STMIK LIKMI-SCHOOL OF BUSINESS & IT

@foreach($diploma as $row) @endforeach
A. PERSONAL DETAILS
Full name: {{ $row->nama_lengkap }}
Place / date of birth: {{ $row->tempat_lahir }}, {{ $row->tanggal_lahir }}
Home address: {{ $row->alamat }}
Home phone number: {{ $row->telepon_rumah }}
Mobile number: {{ $row->nomor_telepon }}
Email address: {{ $row->email }}

@foreach($diploma as $key) @endforeach
B. ACADEMIC BACKGROUND
Name of previous school: {{ $key->pendidikan_terakhir }}
Address of previous school: {{ $key->alamat_sekolah }}
Curriculum used: {{ $key->kurikulum }}
What is your current qualification: {{ $key->current_qualification }}

@foreach($diploma as $key) @endforeach
C. PARENTS/ GUARDIAN DETAILS
Father:
Name : {{ $key->nama_ayah }}
Mobile Number : {{ $key->nomor_ayah }}
Email : {{ $key->email_ayah }}
Mother:
Name : {{ $key->nama_ibu }}
Mobile Number : {{ $key->nomor_ibu }}
Email : {{ $key->email_ibu }}
Guardian(if opted):
Name : {{ $key->nama_wali }}
Mobile Number : {{ $key->nomor_wali }}
Email : {{ $key->email_wali }}




@foreach($diploma as $program)
UNI-BRIDGE DIPLOMA PROGRAM IN ASSOCIATION WITH STMIK LIKMI-SCHOOL OF BUSINESS & IT

Please find attached the following document:
  • School report – Year 12 (Semester 1 & 2)
  • Senior High School Certificate of Completion
  • Proof of English proficiency equivalent o IELTS 5,0 (overall band)
  • Copy of passport (personal page only) and ID Card
  • Copy of family registration card

I hereby acknowledge that all of the above information provided to Uni-bridge, is true to the best of my knowledge. I further allow Uni-bridge to carry further assessment on the above information should it prove to be necessary. I also allow Uni-bridge to process my application to the institution & program overseas that I have selected.

01 Jan 1970




_____________________________

({{ $program->nama_lengkap }})

_____________________________

({{ $program->nama_ayah }})


@endforeach