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MAHSA University Scholarship Form

* Please ensure all details are correct and attachments are submitted. Incomplete forms will be rejected.

APPLICATION FORM

Type of Scholarship: ________________________________________________________________________________________________________

Part I: Personal Information

Name (as in NRIC/ Passport):

Home Address:

Correspondence Address:

IC No.: - - Age: years

Date of Birth (dd/mm/yyyy): - -

Intake: - - Programme: ________________________________________

Nationality: ___________________________________ Race: _________________________________ Sex: Male Female

Contact No. : Mobile - Home -

Household (Monthly Income): RM _____________________________ Student (Monthly Income): RM ___________________________

Email Address: ______________________________________________________________________________________________________________

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Part II: Family Background

No. Name of Parents/Guardian & Siblings /Other Dependents Relationship Age Occupation Monthly Income
Part III: Education Background

Name of school:

Highest Academic Qualification: (Please (x) and state year)

SPM STPM A-Levels UEC Matriculation Others (Please state): _________________________

Please attach Certified True Copies of all relevant qualifications

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Part IV: Extra Curricular Activities

No. Name of Club/ Society/ Association Position Year Achievement

State briefly as to why you are deserving of this Scholarship

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MAHSA University hereby offers the MAHSA University Scholarship CONSIDERATION
(hereinafter referred to as “Scholarship”) to the Student subject to the In consideration of MAHSA University granting the Scholarship to the
terms and conditions stated hereinafter. Scholar, the Scholar hereby agrees and undertakes to comply with the
terms of this Agreement and the specific terms of the Scholarship.
DEFINITION:
MAHSA University: a university duly registered under the Ministry of BREACH
Education bearing registration number KPT/JPT/DFT/US/W16 In the event the Student breaches the terms of this Agreement, MAHSA
Management: refers to the Management of MAHSA University. University has the right to withdraw or terminate the Scholarship and the
Scholar: the recipient of the scholarship whose name and details Scholar has to refund to MAHSA University the amount of Scholarship
appears in the application form for the Scholarship. disbursed within seven (7) days from the date of notification of the
Guarantor: refers to the person who has jointly and severally agreed with withdrawal or termination of the Scholarship. In the event the Student fails
the Student to refund the Scholarship where the Scholarship is to refund the scholarship and/or fails to pay the outstanding sum, MAHSA
terminated or withdrawn pursuant to the terms and conditions stated University has the right to withhold any transcript, certificates and
herein. documents and demand for the payment forthwith with interest at the rate
of 1.5 % per month.
ELIGIBILITY:
The Scholarship is granted to the Student who has complied with the PRIVACY STATEMENT
criteria as set forth by MAHSA University:- The personal information (hereinafter referred to as “Data”) collected in
this application form or otherwise for the purpose of the Scholarship and
(a) The Scholarship is open to all MAHSA University’s enrolled students; is processed, used and retained by MAHSA University in accordance with
(b) The Student shall comply with the entry requirement for the the Data Protection Act 2010 (PDPA 2010). The Data may be collected or
disclosed to relevant bodies for the purposes of verification of grades,
programme or course applied for;
qualification and experiences or as otherwise required by MAHSA
(c) The Student is required to provide information on the family’s
University by applicable laws or relevant authorities. MAHSA University
financial position and/or Guarantor, as stated in the Scholarship
may also retain and continue to retain, process or use the Data for
Application form; and
archiving purposes, alumni, for the purposes of maintain the grades and
(d) Any other relevant documentation as requested or required by qualification or experiences as may be required by MAHSA University. All
MAHSA University documents provided shall be the property of MAHSA University and will
not be returned to the Student. The Student has the right to access or
APPLICATION PROCESS & SUPPORTING DOCUMENTS:
update the Data or make inquiries or submit concerns that may arise by
The Student shall complete the application Form for the Scholarship and contacting the Admissions & Records Department of MAHSA University.
submit the application form together with the following documents to the
Prospective Student Office:-
The Student confirms and acknowledges that the personal information
(a) Completed Scholarship Application form; data collected pursuant to this application form is given voluntarily and the
Student that MAHSA University
(b) 1 Passport size photograph;
(c) Certified true copy of the Student’s NRIC/Passport; CONFIDENTIALITY
(d) Certified true copy of the Guarantor’s NRIC/Passport; The Student hereby agrees to maintain the confidentially imposed by
(e) Certified true copies of the examination certificates and/or MAHSA University for the Scholarship granted to the Student by and shall
transcripts; not disclose the details of the Scholarship to anyone with MAHSA
(f) Extracurricular certificates; University’s express consent.
(g) Latest EA/E Form (Income Tax Returns Form) and/or
Parent/Guardian’s three months pay slip or any documentary JURISDICTION AND COURT
evidence of financial hardship In the event of any dispute which cannot be resolved amicably, Parties
agree to be subjected to the jurisdiction of the courts of Malaysia and the
The Student must submit the certified true copy of the actual results. laws of Malaysia.
Forecast results are not acceptable.
ASSIGNMENT
The Student may be required to attend an interview for the purposes of This Scholarship is not assignable.
the Scholarship and the date, time and venue of the interview will be
informed to the Student. NOTICES
Notices are to be in writing and shall be sent to the address and/or email
MAHSA University shall inform all applicants on the outcome of the as stated hereunder and the Student and/or the Guarantor shall be
Scholarship 1 month after the closing date of the application for deemed to have received the said notices accordingly
scholarship.
GENERAL
The scholar shall be required to confirm acceptance of the Scholarship MAHSA University has the right to withdraw or suspend the Scholarship if
within one (1) week from the date of notification and shall provide a the Student has failed, neglected or omitted to adhere to the Student’s
Guarantor to guarantee the repayment of the Scholarship pursuant to the responsibility and obligations as stated herein.
terms and conditions stated herein.
MAHSA University reserves the right to change the selection criteria and
The Student undertakes to pay any fees incurred that are not covered by Scholarship policy without prior notification.
the Scholarship.
MAHSA University reserves the right to withdraw the Scholarship should
the information furnished by the Student is found to be false, misleading
OBLIGATIONS OF THE SCHOLAR or untrue.
The Scholar must be enrolled as a Student at MAHSA University and
shall be responsible to: MAHSA University has the right to use the Student’s examination details
for the purposes of marketing subject always to the Student’s right under
(a) comply with the rules and regulations as set forth by MAHSA the Data Protection Act 2010.
University;
(b) maintain the required academic achievement for the duration of the
Scholarship;
(c) carry out scholarly work which shall be allocated by the Registrar’s
Office.

I, the Student named hereinafter hereby declare that the I the Guarantor named hereinafter hereby acknowledge that I have
information provided herein is true and correct at the read, understood and agree to be jointly or severally liable for the
time of this agreement. I confirm and acknowledge that I refund of the Scholarship as stated above
have read, understood and agree to the terms stated
above

_________________________________________________
_________________________________________________ Name:
Name: NRIC/ Passport No:
NRIC/ Passport No: Telephone/Mobile No:
Student ID No: Email:
Address:
SCHOLARSHIPS AND GRANTS AT MAHSA UNIVERSITY

These Scholarships and Grants are open to students registered with

MAHSA University.
7. Family Scholarship
1. Sports Scholarship
The Family Scholarship supports the pursuit of higher education of the
The Sports Scholarships is a tribute to students who actively participate in
whole family of a MAHSA Student / Alumni.
sports even while they are pursuing a higher education.
Programmes Eligible : All
Programmes Eligible : All
Level of Study : All
Level of Study : Pre-University, Diploma and Degree
Selection Criteria : Parents, Children and Siblings of MAHSA
Selection Criteria : Students who are enrolled at MAHSA
students / alumni
University and actively participating in sports
Application Deadlines : 30 April, 31 July, 31 October
at the national or state level
Application Deadlines : 30 April, 31 October
8. The Single - Parent Scholarship
The Single - Parent Scholarship recognises the financial challenges of the
2. Haji Abdullah Academic Excellence Scholarship
single parent and supports the education of the child
The Haji Abdullah Academic Excellence Scholarship is offered to students
who have risen above their underprivileged backgrounds to excel both
Programmes Eligible : All
academically and in extra-curricular activities.
Level of Study : All
Selection Criteria : Malaysian Children of Single Parents
Programmes Eligible : All
Application Deadlines : 30 April, 31 July, 31 October
Level of Study : Diploma and Degree
Selection Criteria : Students who can demonstrate financial
constraints and are excelling both
9. The Bandar Saujana Putra Scholarship
academically and in extra-curricular activities
The Bandar Saujana Putra Scholarship supports the efforts of the local
Application Deadlines : 30 April, 31 July, 31 October
community to learn and grow. This scholarship is awarded to any student
from the township of Bandar Saujana Putra (postcode 42610)
3. Foundation Scholarship
Programmes Eligible : All
The Foundation Scholarship is merit-based and offered to students who
Level of Study : All
have completed SPM and O Levels with outstanding results.
Selection Criteria : Residence of Bandar Saujana Putra
Programmes Eligible : All Application Deadlines : 30 April, 31 July, 31 October
Level of Study : Pre-University
Selection Criteria : Malaysian students with a minimum of 5A’s in
10. Graduate Research Scholarship
SPM or O Levels
The Graduate Research Scholarship is awarded to postgraduate students
Application Deadlines : 30 April, 31 July
demonstrating high research potential to undertake research at MAHSA
University.
4. Continuing Education Scholarship
Programmes Eligible : All postgraduate research programmes
The Continuing Education Scholarship rewards students who are enrolled
Level of Study : Masters and PhD
in a pathway programme.
Selection Criteria : Research area and interview
Programmes Eligible : All Application Deadlines : 30 April, 31 October
Level of Study : Next Level
Selection Criteria : Current MAHSA students enrolled on a
11. MAHSA Special Scholarship
pathway programme
This Scholarship is open to all MAHSA University students. The
Application Deadlines : 30 April, 31 July, 31 October
Management reserves the right to award this Scholarship subject to
additional terms and conditions as it sees fit.
5. Alumni Scholarship
Programmes Eligible : All
The Alumni Scholarship is open to all alumni across the MAHSA Education
Level of Study : All
Group.
Selection Criteria : Special consideration upon Submission of CV
and interview by Scholarship panel
Programmes Eligible : All
Application Deadlines : 30 April, 31 October
Level of Study : All
Selection Criteria : MAHSA graduates enrolled for a second
qualification
Application Deadlines : 30 April, 31 July, 31 October

6. School Teachers Scholarship

The School Teachers Scholarship appreciates and recognizes the
contribution of all school teachers in nation building. We welcome them and
their families to MAHSA University.

Programmes Eligible : All

Level of Study : All
Selection Criteria : Malaysian School Teachers, their children and
spouses
Application Deadlines : 30 April, 31 July, 31 October
FOR OFFICE USE ONLY

Prospective Student Office

Document Checklist

√ Documents
Completed Scholarship Application form
1 Passport size photograph
Certified true copy of the Student’s NRIC/Passport
Certified true copy of the Guarantor’s NRIC/Passport
Certified true copies of the examination certificates and/or transcripts
Extracurricular certificates
Latest EA/E Form (Income Tax Returns Form) and/or Parent/Guardian’s three (3) months pay slip or any documentary evidence of financial hardship

Documents complete Documents Incomplete

Checked by

Name : _____________________________ Signature : _______________________________

Position : _____________________________ Stamp : _______________________________

Date : _____________________________

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Registrar’s Office

Verified by

Name : _____________________________ Signature : _______________________________

Position : _____________________________ Stamp : _______________________________

Date : _____________________________

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Scholarship Committee

Date of meeting : ________________________________ Status (approved / rejected) : ____________________________________

Amount approved : ________________________________ Scholarly work required (hours) : ____________________________________

Approved by

Name : _____________________________ Signature : _______________________________

Position : _____________________________ Stamp : _______________________________

Date : _____________________________

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Finance Department

Received by

Name : _____________________________ Signature : _______________________________

Position : _____________________________ Stamp : _______________________________

Date : _____________________________

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System recorded by:

Name:__________________________________ Signature:_______________________________ Date:____________________________________