S/NO: PLP/KCH/2020_Jan

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PUSAT LATIHAN PROAKTIFISO 9001: 2008

Lot 2331-2335, Jalan Simen Raya, Pending Industrial Estate, Pending Industrial Estate, 93450 Kuching, Sarawak Tel: 082-480868 Fax: 082-330464 Website: www.plproaktif.edu.my

COURSE APPLICATION FORM USE CAPITAL LETTERS / GUNAKAN HURUF BESAR * Mandatory to be fill / Wajib diisi

PART A: PERSONAL DETAILS / Butir-Butir Peribadi

* Full Name (as per IC) / Nama Penuh (mengikut KP)

* I.C. No. / No. K.P. * Nationality / Warganegara

* Date of birth / Tarikh Lahir * Race / Bangsa

* Status: * Gender/Jantina:

Married /Berkahwin Single /Bujang Male / Lelaki Female/Perempuan

* Home Address / Alamat Rumah:

Postcode :

* Home Phone Number / Telefon Rumah: * Office Telephone Number / Telefon Pejabat:

- -

* H/P Number / Telefon Bimbit: Fax Number / Nombor Faks:

- -

* E-mail: _______________________________________

* EDUCATION BACKGROUND / Latar Belakang Pendidikan

Name of School / College / University Nama Sekolah / Kolej / Universiti

Qualification Kelayakan

Year Tahun

Please glue one

passport sized

photo here /

Lekat satu

gambar bersaiz

passport di sini

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* Working Experience / Latar Belakang Pekerjaan

Job’s Title / Position Jawatan Dipegang

Name of Organisation Nama Organisasi

Period (Months / Years) Tempoh (Bulan / Tahun)

* PROFICIENCY IN LANGUAGES / Kecekapan Bahasa

Please tick (√) the appropriate box / Sila tandakan (√) dalam kotak yang berkenaan

LANGUAGES PROFICIENCY EXCELLENT GOOD FAIR WEAK

English Written

English Oral

Bahasa Malaysia Written

Bahasa Malaysia Oral

Others: _________________ Written

Others: _________________ Oral

PART B: PARENTS / GUARDIAN’S / SPOUSE’S INFORMATION

* PARENTS / GUARDIAN’S NAME / NAMA IBU / BAPA / PENJAGA / SPOUSE

* Contact No (H/P) / No Telefon (H/P) * Contact No Home/Office/No Tel Rumah/Pejabat

- -

* Mailing Address / Alamat Surat Menyurat:

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DECLARATION AND SIGNATURE / Pengesahan Dan Tandatangan

I declare that the information provided by me in this application is true and correct. I acknowledge that Pusat

Latihan Proaktif reserves the right to vary or reserves any decision regarding admission or enrolment made on

the basis of incorrect or incomplete information. I accept terms and conditions executed by Pusat Latihan

Proaktif.

Saya mengesahkan bahawa semua maklumat dalam pemohonan ini adalah sahih dan benar. Saya bersetuju

bahawa Pusat Latihan Proaktif berhak untuk mengubah keputusan berkenaan kemasukan sekiranya maklumat

yang saya berikan adalah tidak benar atau tidak lengkap. Saya menerima terma dan syarat yang dimaktubkan

oleh Pusat Latihan Proaktif.

………………………………………………….. …………………………………………….. Signature of Applicant Date Tandatangan Pemohon Tarikh

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PART C: COMPETENCY COURSES APPLICATION

Please provide the course code apply. Refer to Appendix A attached. /Sila isi kod kursus yang dipilih mengikut Lampiran A yang dikepilkan.

No Course Code Apply / Kod Kursus Yang Dipohon Date / Tarikh

1.

2.

3.

4.

5.

6.

PART D: TERMS AND CONDITIONS

1. Application form must be properly completed and attached with the relevant documents as stated in our application form. Photograph of the applicant must be attached to the application form.

2. RM20.00 Enrollment Fee to be enclosed together with the application form submission. This fee is non-transferable and non-refundable.

3.

a) A deposit of RM200.00 for all competency courses to be paid upon receipt of the Letter of Acceptance from Pusat Latihan Proaktif. b) A deposit of RM50.00 for all short courses to be paid upon receipt of the Letter of Acceptance from Pusat Latihan Proaktif. The deposit is non-transferable and non-refundable.

4. The deposit will be forfeited if the candidate fails to attend the class on the registered date. The deposit will be brought forward to the next available class if Pusat Latihan Proaktif fails to conduct the class on the registered date.

5. The Letter of Acceptance from Pusat Latihan Proaktif will be sent or given out to the student before the commencement of the class or on the first day of class.

6. The remaining final balance of your Course Fee must be paid prior to the commencement of the Course practical class; failing which the Management of Pusat Latihan Proaktif reserves the right to disallow the continuation of the student’s class.

7. Course Fee is non-transferable and non-refundable.

8. Students must adhere strictly to the Rules and Regulations of the Training Centre. No stealing and photographing are allowed during and around the training premises. Anyone caught will be penalized accordingly.

9. The Management of Pusat Latihan Proaktif reserves the right to withdraw any application should be information given is found to be false.

10. For participants residing outside Kuching (eg. Bintulu, Sibu, Miri), DO NOT book / purchase your air ticket before getting a confirmation from Pusat Latihan Proaktif.

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PART E: APPLICATION CHECKLIST / Senarai Semak Permohonan

PART F: PAYMENT METHOD

No. ITEM Check /

Semak (√)

1 All sections of the form must be completed and the declaration signed and dated. Semua bahagian borang mesti diisi dan deklarasi ditandatangani.

√

2 Enclose one certified copy of I.C. and all academic certificates and transcripts. Kepilkan satu salinan kad pengenalan dan sijil akademik dan transkrip yang disahkan.

√

3 Enclose a copy of your resume. Kepilkan satu salinan resume.

√

4 Attach ONE (1) passport sized photo Kepilkan SATU (1) gambar bersaiz passport.

√

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Send complete application to: Hantar permohonan yang lengkap kepada: PUSAT LATIHAN PROAKTIF LOT 2331-2335, JALAN SIMEN RAYA PENDING INDUSTRIAL ESTATE 93450 KUCHING, SARAWAK TEL: 082-480868 FAX: 082-330464 Website: www.plproaktif.edu.my

√

1. CASH

2. CHEQUE (Please issue under Proaktif Electrical Sdn Bhd (Acct No. RHB 2111 460 001 4657)

3. ATM Transfer / Internet Banking

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PART G: CHECK LIST FOR SCHOLARSHIP’S APPLICATION / Senarai Semak Permohonan Biasiswa

Kindly attach herewith the required supporting documents: Sila kepilkan bersama dokumen sokongan:

Student (Pelajar)

(a) 1 photocopy of IC (Salinan Kad Pengenalan)

(b) 2 passport size photo (2 keping gambar berukuran passport)

(c) Birth certificate (Sijil lahir)

(d) SPM and SRP certificate, PMR, STPM, Diploma or Degree certificate (Salinan sijil SRP, SPM, Diploma ataupun Sarjana)

(e) School relevant certificates (Aktiviti Ko-kurikulum - kegiatan sukan, persatuan/kelab sekolah/pasukan pakaian seragam dan sebagainya)

(f) School leaving certificate (Sijil berhenti sekolah)

Parents / Guardian (Ibubapa / Penjaga)

(a) Parents / Guardian photocopy IC – 1 each (Salinan kad pengenalan ibubapa / penjaga)

(b) A copy of 1 month (recent) pay slip (Salinan penyata gaji sebulan yang terkini samada daripada ibubapa / penjaga yang bekerja)

(c) If no source of regular income, please submit a letter from the Ketua Kampung / Penghulu as evidence (Jika tiada surat punca pendapatan tetap, sila kemukakan surat pengesahan dari Ketua Kampung / Penghulu sebagai bukti)

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APPENDIX A – CODE COURSE

COMPETENCY COURSE

WG2 Wireman Grade 2 – Single Phase WG1 Wireman Grade 1 – Three Phase

CML1 Chargeman L1 (415v System) CML2 Chargeman L2 (Overhead Line) CML3 Chargeman L3 (Genset Synchronising) CMH1 Chargeman H1 (High Voltage) CML4 Chargeman L4 (PV Standalone Systems)

BCEW Building Contract Electrical Wiring (BCEW) ATT Authorized To Test SF6 SF6 Gas Handling & Management Requirement LVDS Low Voltage Distribution & Switching FA First Aid BULATS Cambridge English Language IHWC-SL Innovative High-End Wood Craftman – Skill Level IHWC-PL Innovative High-End Wood Craftman – Professional Level DLEC Digital Laser Engraving and Cutting CADCAM Industrial Digital 3D CNC Designing & Programming 3D CNC Industrial Digital 3D CNC Printer

SHORT COURSE EO&S Electrical Ordinance & Safety EP Electrical Principle ES Earthing System EPS Electrical Protection System CIDB Award (CCD Point) GT&C Solar HV & T&C

CIDB/Genset Testing & Commissioning (GT&C) CIDB/Photovoltaic (Solar) Servicing & Preventive/Predictive Maintenance (SOLAR S&PM) CIDB/High Voltage Testing & Commissioning (HV-T&C)

WEEKEND COURSE G2 - WK Wireman Grade 2 G1 - WK Wireman Grade 1 L1 - WK Chargeman L1

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