JWC Academy Enrollment Form

Programme

Programme Name *

Intake Year *

Version *

Venue *

Student Information

English Name (NRIC Name) *

Chinese Name *

Passport/ NRIC No. *

Gender *

Male
Female

Date of Birth *

Passport / NRIC Photocopy (Front & Back in one page) *

Click or drag a file to this area to upload.

Age *

Nationality *

Religion

Race / Ethnicity

Phone *

Email *

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Education Background

Year *

Name of Secondary School / Institute *

SPM / UEC *

SPM
UEC

Parent / Guardian Information

English Name (Father) *

Chinese Name (Father) *

NRIC No. (Father) *

Phone (Father) *

Passport / NRIC Photocopy (Father)(Front & Back in one page) *

Click or drag a file to this area to upload.

English Name (Mother) *

Chinese Name (Mother) *

NRIC No. (Mother) *

Phone (Mother) *

Passport / NRIC Photocopy (Mother)(Front & Back in one page) *

Click or drag a file to this area to upload.

Emergency Contact

Guardian *

Father
Mother
Guardian not parent

Full English Name *

Chinese Name *

NRIC No. *

Phone *

Relationship with Student *

Bank Information

Bank

Bank Account No.

Account Holder

Account Holder NRIC No.

Remark

T-Shirt Size

S
M
L

Loan Apply

Yes
No

Hostel Apply (apply to student@newera.edu.my)

Yes
No

KOJADI Loan Apply

Yes
No

Special Remark

Course & Payment Structure

Course (Barista Weekend Course)

Foundation Weekend Course - RM1300
Intermediate Weekend Course - RM1600
Advanced Weekend Course - RM2200
Full Weekend Course (iNSTA) - RM2652

Course (Bread Baking Weekend Course)

Foundation Weekend Course - RM1300
Intermediate Weekend Course - RM1600
Advanced Weekend Course - RM2200
Full Weekend Course (iNSTA) - RM2652

Payment Method *

Payment Slip *

Click or drag a file to this area to upload.

Counsellor Name *

Installment Plan Application

File Upload

Click or drag a file to this area to upload.

Please fill out the form and submit to below column
Link for download the form: Installation Payment Application Form

Confirm and Click Here *

I hereby acknowledge that I have read, understand and agree to the terms of this application form and tuition fee payment structure. And also, I am currently in good health and free from malignant and legal communicable diseases, mental illness, epilepsy, physical and mental disabilities, etc. In the event during my studies that I have suffer from any of the above-mentioned diseases or conditions, I am responsible to inform to the university immediately. Failure to do so, the university has the right to make the decision to either defer or discontinue my studies or make any suitable arrangement for me, I am duly agree to comply with such decision and further understand that all fees paid are not refundable.

IMPORTANT:

By submitting this form, you acknowledge all fees, charges and accounts will be payable in advance as determined by JWC Coffee Academy from time to time.

Students will not be permitted to commence or continue their studies at the beginning of any semester until all outstanding fees, charges or accounts are paid.

Students have to confirm that they have read and understood the terms and conditions outlined in offer letter, and accept the offer of admission.

Please note that once your payment done you can't get a refund for any payments you've already made.

JWC Academy Enrollment Form

Programme

Student Information

Education Background

Parent / Guardian Information

Emergency Contact

Bank Information

Remark

Course & Payment Structure

Installment Plan Application

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