Scholarship Application | B.P. Renal Care

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Choose A Scholarship Programme

Scholarship Programme

Course Name

Intake

University

University Name

SECTION A: PERSONAL INFORMATION

Name

NRIC

Mobile Number

Date of Birth

Home Address

Height (cm)

Weight (kg)

BMI

SECTION B: QUALIFICATION

No.	Sijil Pelajaran Malaysia (SPM)	Grade	Action
exp.	Bahasa Malaysia	A	-

No.	Sijil Tinggi Pelajaran Malaysia (STPM)	GPA	Action
exp.	Bahasa Malaysia	3.0	-

University CGPA

MUET (Band)

SECTION C: FAMILY INFORMATION

Father’s / Guardian 1’s Name

NRIC

Mobile Number

Occupation

Salary (RM/Monthly)

Mother’s / Guardian 2’s Name

NRIC

Mobile Number

Occupation

Salary (RM/Monthly)

Dependents In The Family :

No.	Full Name	Relationship	Date of Birth	Occupation / Student	Company Name / University Name	Action
exp.	Full Name One	Sibling	23/07/1997	Student	UTEM	-

Are you staff of BPRC Group of Companies?

Yes

Do you have any family members or relatives currently working at BPRC Group of Companies?

Yes

Name of Family Member/Relative

Family Member/Relative NRIC

BPRC Group of Companies

Relationship to Applicant

Supporting Document :

No.	Name	Document
1.	Applicant IC Photostat
2.	SPM Result
3.	STPM/ O-LEVEL Result
4.	MUET Result
5.	School Leaving Certificate
6.	Parents/Guardian Payslip (latest 3 months) or Salary Verification Letter from JKKK
7.	Applicant Bank Account Verification Letter
8.	PDPA Form (Click Here)
9.	University Offer Letter
10.	Medical Check-up Result
11.	MOCK SPM Result

DECLARATION

I hereby grant consent to BPRC Sdn. Bhd. to process my personal data in accordance with the Personal Data Protection Notice.

I declare that the information contained in this application form and in the attached documents are true and accurate to the best of my knowledge at this time.