Application for Financial Assistance

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Father / Mother / Guardian
Family / Siblings Details





I hereby declare that the details furnished above are true and correct to the best of my knowledge and belief and I undertake to inform you of any changes therein, immediately. I hereby authorize sharing of the information furnished on this form with the YAYASAN UNIVERSITI MULTIMEDIA (YUM). In case any of the above information is found to be false or untrue or misleading or misrepresented, I am aware that I may be held liable for it and YAYASAN UNIVERSITI MULTIMEDIA (YUM) has the right to disqualify this application or blacklist my name.