Domestic Application

Centralised System

Notes :

Please go to BSN (Bank Simpanan Nasional) and get PTPTN pin number by showing your IC.Please note without PIN number LUC cannot apply to PTPTN.

Select Program :

IC Number :

Applicant Full Name :

Date Of Birth :

Gender :

MaleFemale

E-mail Id :

Alt E-mail Id :

Marital Status :

SingleMarriedDivorceWidow

Personal Mobile Number:

Permanent Address :

City :

Postal Code :

Country :

State :

Mobile Number :

Resident Number :

Check If (Same as Above)

Correspondence Address :

City :

Postal Code :

Country :

State :

Mobile Number :

Resident Number :

Father's Name :

Fathers Tel No. :

Father's Occupation :

Mother's Name :

Mothers Tel No. :

Mother's Occupation :

Gurdians Name :

Gardians Tel No. :

Gurdians Occupation :

Highest Qualification :

Year Of Passing :

Overall Grade :

I hereby declare that all the information given above is true at my best knowledge