A1 – Admission Registration(international student) – Student Portal

Personal Details
Name*
Gender*
Date of Birth*
Place of Birth*
Nationality*
Identity Card No.*
Identity Card Colour
Passport Details
Passport No.*
Valid passport (expiry date of not less than 6 months).
Copy of Passport*
Drop files here or
Front page and page of entry/chop
Place of Issued
Expiry Date
Medical Details
Copy of Medical Certificate*
Drop files here or
Medical fitness certificate(including x-ray) issued by a registered medical practitioner stating that you are medically fit to study in Brunei. All charges incurred for the medical expenses are to be borne by yourself.
Student pass Details
Copy of Student pass*
Drop files here or
Attached Student Visa
Programme Details
Registration ID No.
Faculty / Centre
Programme
Academic Year
Mode of Study
Source of Funding
In-Service Training Ref No.
Contact Details
Email*
UNISSA Email
Address (Brunei)*
Address (Home Country)
Telephone No. (Home)
Telephone No. (Mobile)*
Guardian's Details
Guardian's 1 Name*
Guardian's 1 Contact No.*
Guardian's 2 Name
Guardian's 2 Contact No.
Contact Person In Case Emergency
Name*
Relation*
Address*
Telephone No. (Home)
Telephone No. (Mobile)*
Telephone No. (Office)
Student Declaration
Date*
Date Format: DD slash MM slash YYYY
*
- I hereby verify that all information on this form is true and correct to the bes t of my knowledge.

Personal Details