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STUDENT APPLICATION FORM

Please complete all required sections.

Step 1 of 5: Student Particulars
20% Complete
1. Student Particulars
Leave blank if not applicable
2. Parents or Guardian Details

Fill in the details for those applicable. At least one of Father, Mother, or Guardian is required.

Father
Mother
Guardian (Optional)
3. Education Background
High School / Secondary Level
English Qualification (Please Provide Highest English Qualification)
Higher Education (Highest Qualification if Applicable)
4. Course & Institution Selection

At least 1 preference is required. Preferences 2 to 5 are optional, including for UCAS-related cases.

5. Funding & Declaration
Funding Details
Academic Referral (Optional)
Declaration & Signature
EDUMi.my Logo Agra Edu Logo

STUDENT APPLICATION FORM

EDUMi Sdn. Bhd. and Agra Edu Sdn. Bhd.

Student Submission Record
Student Particulars
Title Gender
Full Name
Passport / ID No. Date of Birth
Origin Country Email
Address ,
Contact Number
Parents or Guardian Contact Details
Relation Name Occupation Contact
Father
Mother
Guardian
Guardian Address ,
Education Background
High School / Secondary Level Year Finished
English Qualification
Level of Qualification Institution
Qualification Current Status
Overall Results Graduation
Course Dates to
Academic Referral
Referral Name Telephone Email
1st Referral
2nd Referral
Course / Institution Selection
No Country Institution Level Course
1
2
3
4
5
Intake
Funding, Notes and Representative
Funding Type Household Salary Range
Sponsor Name
Scholarship Countries
Applied Through Other Agent Agent Name
Source of Enquiry Representative Serving
Special Notes
Terms and Conditions of Application

1. Scope of Representation: By submitting this application form, the student agrees to appoint EDUMi.my and/or Agra Edu Sdn. Bhd. as the official education consultant to represent the student in submitting applications to universities or colleges listed in this form.

2. Accuracy of Information: The student confirms that all information provided is true, complete, and accurate to the best of their knowledge.

3. University Application Submission: EDUMi.my will assist in submitting applications based on the student’s selected preferences, subject to eligibility and institutional requirements.

4. Application Fee Coverage: All university application fees must be paid by the student.

5. Processing and Communication: The student agrees to cooperate by providing required documents within a reasonable timeline to avoid delays.

6. Limitation of Liability: EDUMi.my shall not be held liable for institutional decisions, changes in admission requirements, intake availability, or third party timelines.

7. Consent and Acknowledgement: By signing this form, the student confirms agreement to the above terms and conditions.

Student Signature
Full Name
Date
Submission Checklist
  • Completed Agra / EDUMi.my Application Form
  • Curriculum Vitae / Resume
  • High School exam results (SPM, IGCSE)
  • English qualification result
  • Academic transcript
  • IELTS results if applicable
  • Copy of passport main page
  • Copy of Malaysia identity card front and back
  • Proof of work experience if applicable
  • Personal statement
  • Reference letter optional
  • Passport sized photo
EDUMi.my Student Application Document