To Join our Course, just complete this form and make a payment
direct to the college account from your bank to our bank by telegrafic transfer (t.t.) and sent this form alongwith the
payment slip that you have made in your country.
Application Form
Name of Course Interested:.....................................
( Hijamah, Acupuncture, Homeopathy, etc)
Name In Full:...................................................................
Full Postal Address..........................................................
.........................................................................................
.........................................................................................
Passport or IC No: .........................................................
Tel No (Res)....................................................................
Tel No. Office................................................................
E Mail :..........................................................................
Date of Birth:...........................................Age:.....................
Occupation:..........................................................................
Attach:
1. 2 passport size photograph
2. Bank Slip
Pay direct to the college Account
Name of College:
Fakulti Perubatan Homeopathy Malaysia
Name of Bank: O C B C Bank
Kuala Lumpur, Malaysia
Account No: 755 101 9716
Note: Please pay by telegrafic transfer or t.t. from your bank to our OCBC Bank
in Kuala Lumpur.
Sent your application Form direct to the college.
To
The Registrar
Fakulti Perubatan Homeopathy Malaysia
No.122 Taman University, Kg Gelang Mas,
17010 Pasir Mas, Kelantan,
Malaysia.