/akn/my/act/pua/2018/53
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PERATURAN-PERATURAN INSTITUSI PENDIDIKAN TINGGI SWASTA (PENUBUHAN INSTITUSI PENDIDIKAN TINGGI SWASTA DAN CAWANGAN) 2018 is Malaysia P.U. (A), cited as P.U. (A) 53 2018, currently marked in force and first recorded in 2018.
Opening note
Peraturan-peraturan ini bolehlah dinamakan
Peraturan-Peraturan
Institusi Pendidikan Tinggi Swasta (Penubuhan Institusi Pendidikan Tinggi
Swasta dan Cawangan) 2018.
Peraturan-Peraturan ini mula berkuat kuasa pada 23 Februari 2018.
Permohonan bagi kelulusan untuk menubuhkan institusi pendidikan tinggi swasta
Suatu permohonan bagi kelulusan untuk menubuhkan suatu institusi pendidikan tinggi swasta di bawah seksyen 6 Akta hendaklah dibuat oleh pemohon kepada Ketua Pendaftar dalam Borang A sebagaimana yang dinyatakan dalam
Jadual Pertama.
(2)
Permohonan di bawah subperaturan (1) hendaklah disertakan dengan—
(a)
apa-apa dokumen sebagaimana yang ditentukan oleh Ketua Pendaftar; dan
(b)
fi sebagaimana yang dinyatakan dalam Jadual Kedua.
(3)
Fi yang disebut dalam perenggan (2)(b) hendaklah kena dibayar kepada
Ketua Pendaftar.
P.U. (A) 53 3
Keperluan yang ditetapkan 3.
Bagi maksud perenggan 9(c) Akta, keperluan yang ditetapkan adalah seperti yang berikut:
(a)
pemohon itu berkebolehan untuk menyediakan tapak dan premis bagi kegunaan institusi pendidikan tinggi swasta itu;
(b)
pemohon itu mempunyai pengalaman yang bersesuaian atau rekod prestasi yang cemerlang dalam pendidikan;
(c)
pemohon itu berkebolehan untuk menyediakan guru yang berkelayakan dan berpengalaman dalam bidang yang berkaitan bagi institusi pendidikan tinggi swasta itu;
(d)
pemohon itu mempunyai kedudukan kewangan yang kukuh dan berkebolehan untuk menyediakan pengurusan kewangan yang baik bagi institusi pendidikan tinggi swasta itu; dan
(e)
pemohon itu berkebolehan untuk mengendalikan kursus pengajian atau program latihan secara bersendirian atau secara bergabung, bersekutu atau bekerjasama dengan mana-mana institusi pendidikan tinggi swasta atau badan profesional.
Modal terbitan dan berbayar atau dana permulaan syarikat 4.
(1)
Bagi maksud perenggan 12(1)(a) Akta, modal terbitan dan berbayar bagi pemohon itu hendaklah tidak kurang daripada satu juta ringgit.
(2)
Bagi maksud perenggan 12(1A)(a) Akta, dana permulaan bagi pemohon itu hendaklah tidak kurang daripada satu juta ringgit.
P.U. (A) 53 4
Permohonan bagi kelulusan untuk menubuhkan cawangan 5.
(1)
Suatu permohonan bagi kelulusan untuk menubuhkan suatu cawangan di bawah seksyen 18 Akta hendaklah dibuat oleh institusi pendidikan tinggi swasta kepada Ketua Pendaftar dalam Borang B sebagaimana yang dinyatakan dalam
Jadual Pertama.
(2)
Permohonan di bawah subperaturan (1) hendaklah disertakan dengan—
(a)
apa-apa dokumen sebagaimana yang ditentukan oleh Ketua Pendaftar; dan
(b)
fi sebagaimana yang dinyatakan dalam Jadual Kedua.
(3)
Fi yang disebut dalam perenggan (2)(b) hendaklah kena dibayar kepada
Ketua Pendaftar.
Pindaan perakuan pendaftaran 6.
Institusi pendidikan tinggi swasta hendaklah mengemukakan perakuan pendaftaran yang dikeluarkan di bawah subseksyen 24(9) Akta kepada Ketua Pendaftar bagi pindaan dalam tempoh tiga tahun dari tarikh kelulusan untuk menubuhkan suatu cawangan di bawah perenggan 18(6)(a) Akta.
Pembatalan 7.
Peraturan-Peraturan Institusi Pendidikan Tinggi Swasta (Penubuhan) 1997
[P.U. (A) 539/1997] dibatalkan.
Kecualian 8.
Semua permohonan yang dibuat di bawah Peraturan-Peraturan Institusi
Pendidikan
Tinggi
Swasta
(Penubuhan)
1997, yang disebut sebagai
“Peraturan-Peraturan yang dibatalkan” di bawah peraturan ini, yang belum selesai sebaik sebelum tarikh permulaan kuat kuasa Peraturan-Peraturan ini hendaklah, pada tarikh permulaan kuat kuasa Peraturan-Peraturan ini, diuruskan di bawah
Peraturan-Peraturan yang dibatalkan seolah-olah Peraturan-Peraturan ini tidak dibuat.
P.U. (A) 53 5
JADUAL PERTAMA
[Peraturan 2 dan 5]
BORANG A
PERMOHONAN BAGI KELULUSAN UNTUK MENUBUHKAN INSTITUSI PENDIDIKAN
TINGGI SWASTA
Ketua Pendaftar Institusi Pendidikan Tinggi Swasta,
Saya memohon bagi penubuhan—
(Nota: Sila tanda (√) mana-mana yang berkenaan)
Universiti
Kolej Universiti
Kampus cawangan luar negeri
Kolej
Nota:
BAHAGIAN I – Untuk diisi oleh syarikat berhad menurut syer
BAHAGIAN II – Untuk diisi oleh syarikat berhad menurut jaminan
P.U. (A) 53 6
BAHAGIAN I
BUTIR-BUTIR PEMOHON
(SYARIKAT BERHAD MENURUT SYER)
1.
Nama syarikat:
___________________________________________________
___________________________________________________
2.
Status syarikat:
(Nota: Sila tanda (√) mana-mana yang berkenaan)
Syarikat awam
Syarikat persendirian
3.
No. Pendaftaran Syarikat:
__________________________________________________
4.
Tarikh pendaftaran:
__________________________________________________
5.
Alamat berdaftar syarikat: __________________________________________________
__________________________________________________
Poskod:
__________________________________________________
Daerah:
__________________________________________________
Negeri:
__________________________________________________
No. Telefon:
__________________________________________________
No. Faks:
__________________________________________________
E-mel:
__________________________________________________
P.U. (A) 53 7
6.
Alamat surat-menyurat syarikat:
__________________________________________________
__________________________________________________
Poskod:
__________________________________________________
Daerah:
__________________________________________________
Negeri:
__________________________________________________
No. Telefon:
__________________________________________________
No. Faks:
__________________________________________________
E-mel:
__________________________________________________
7.
Modal terbitan:
RM __________________________________________________
8.
Modal berbayar:
RM _________________________________________________
P.U. (A) 53 8
9.
Pemegang saham:
Bil. Jenis pemegang saham
(Individu/Syarikat awam/Syarikat persendirian)
Nama penuh dan No. K.P./
No. Pasport atau
Nama syarikat dan
No. Pendaftaran Syarikat
Kewarganegaraan
(jika berkenaan)
Bangsa
(jika berkenaan)
Saham
Nilai
Peratusan
%
Jumlah
(Nota: Jika pemegang saham terdiri daripada suatu syarikat, sila berikan butir-butir terkini semua pemegang saham syarikat itu)
P.U. (A) 53 9
10.
Lembaga pengarah:
Bil.
Nama penuh dan
No. K.P./
No. Pasport
Kewarganegaraan
Bangsa
Profesion
Jawatan dalam syarikat
11.
Kelulusan lain yang telah diberikan kepada pemohon di bawah Akta:
Bil.
Jenis kelulusan
Tarikh kelulusan
No. Rujukan
Catatan
12.
Kepentingan kewangan pemohon dalam perniagaan mana-mana orang atau syarikat lain yang mengadakan atau menguruskan institusi pendidikan tinggi di dalam atau di luar Malaysia:
Bil.
Nama orang/syarikat
(yang mengadakan atau menguruskan institusi pendidikan tinggi)
Nama institusi pendidikan tinggi
Jenis kepentingan kewangan
Nilai
Jumlah
P.U. (A) 53 10
13.
Kepentingan atau hak orang lain dalam perniagaan pemohon termasuk hak untuk menamakan mana-mana pengarah bagi syarikat pemohon:
Bil.
Nama orang/syarikat
(yang mempunyai kepentingan atau hak)
Jenis kepentingan/
hak
Nilai
Jumlah
14.
Urusan perniagaan lain pemohon:
Bil.
Jenis perniagaan
Nama syarikat/
organisasi perniagaan
Jenis penglibatan/
Jawatan
P.U. (A) 53 11
15.
Kepentingan kewangan atau hak orang lain dalam urusan perniagaan lain pemohon:
Bil.
Jenis perniagaan
Nama syarikat/
organisasi perniagaan
Nama orang/
syarikat
(yang mempunyai kepentingan kewangan atau hak)
Jenis kepentingan kewangan/hak
Nilai
Jumlah
BAHAGIAN II
BUTIR-BUTIR PEMOHON
(SYARIKAT BERHAD MENURUT JAMINAN)
1.
Nama syarikat:
___________________________________________________
__________________________________________________
2.
No. Pendaftaran Syarikat:
___________________________________________________
3.
Tarikh pendaftaran:
___________________________________________________
4.
Alamat berdaftar syarikat:
___________________________________________________
___________________________________________________
Poskod:
___________________________________________________
Daerah:
___________________________________________________
P.U. (A) 53 12
Negeri:
___________________________________________________
No. Telefon:
___________________________________________________
No. Faks:
___________________________________________________
E-mel:
___________________________________________________
5.
Alamat surat-menyurat syarikat: ___________________________________________________
___________________________________________________
Poskod:
___________________________________________________
Daerah:
___________________________________________________
Negeri:
___________________________________________________
No. Telefon:
___________________________________________________
No. Faks:
___________________________________________________
E-mel:
___________________________________________________
6.
Anggota:
Bil.
Nama penuh dan No. K.P./
No. Pasport atau
Nama syarikat dan
No. Pendaftaran Syarikat
Alamat tetap/
Alamat berdaftar syarikat
Sumbangan
Jumlah
P.U. (A) 53 13
7.
Lembaga pengarah atau pemegang amanah:
Bil.
Nama penuh dan
No. K.P./No. Pasport
Kewarganegaraan
Bangsa Profesion
Jawatan dalam syarikat
8.
Kelulusan lain yang telah diberikan kepada pemohon di bawah Akta:
Bil.
Jenis kelulusan
Tarikh kelulusan
No. Rujukan
Catatan
9.
Kepentingan kewangan pemohon dalam perniagaan mana-mana orang atau syarikat lain yang mengadakan atau menguruskan institusi pendidikan tinggi di dalam atau di luar Malaysia:
Bil.
Nama orang/syarikat
(yang mengadakan atau menguruskan institusi pendidikan tinggi)
Nama institusi pendidikan tinggi
Jenis kepentingan kewangan
Nilai
Jumlah
P.U. (A) 53 14
10. Kepentingan atau hak orang lain dalam perniagaan pemohon termasuk hak untuk menamakan mana-mana pengarah bagi syarikat pemohon:
Bil.
Nama orang/syarikat
(yang mempunyai kepentingan atau hak)
Jenis kepentingan/
hak
Nilai
Jumlah
11. Urusan perniagaan lain pemohon:
Bil.
Jenis perniagaan
Nama syarikat/
organisasi perniagaan
Jenis penglibatan/
Jawatan
12. Kepentingan kewangan atau hak orang lain dalam urusan perniagaan lain pemohon:
Bil.
Jenis perniagaan
Nama syarikat/
organisasi perniagaan
Nama orang/
syarikat
(yang mempunyai kepentingan kewangan atau hak)
Jenis kepentingan kewangan/
hak
Nilai
Jumlah
P.U. (A) 53 15
BAHAGIAN III
BUTIR-BUTIR INSTITUSI PENDIDIKAN TINGGI SWASTA YANG DICADANGKAN
1.
Tiga nama institusi pendidikan tinggi swasta yang dicadangkan:
Bil.
Bahasa kebangsaan
Bahasa Inggeris 1.
2.
3.
2.
Alamat institusi pendidikan tinggi swasta yang dicadangkan: ___________________________________________________
___________________________________________________
Poskod:
___________________________________________________
Daerah:
___________________________________________________
Negeri:
___________________________________________________
P.U. (A) 53 16
BAHAGIAN IV
KURSUS PENGAJIAN DAN PROGRAM LATIHAN YANG DICADANGKAN
Bil.
Nama kursus pengajian/
program latihan
Bidang
Peringkat
Jenis kursus pengajian
Cara penyampaian
Tempoh kursus
Kelayakan kemasukan
Rakan kongsi kerjasama
(jika berkenaan)
Badan atau institusi yang menganugerahkan
Tahunan
Kursus keseluruhan
BAHAGIAN V
UNJURAN BILANGAN PELAJAR DAN GURU
Bil.
Nama kursus pengajian/program latihan
Bidang
Unjuran bilangan pelajar dan guru
(bagi perancangan lima tahun selepas pendaftaran)
Tahun 1
Tahun 2
Tahun 3
Tahun 4
Tahun 5
Jumlah
(Nota: P: Pelajar, G: Guru)
BAHAGIAN VI
SUMBER KEWANGAN
Bil.
Sumber
Amaun (RM)
Jumlah
17
P.U. (A) 53 18
BAHAGIAN VII
PREMIS DAN KEMUDAHAN
1.
Jenis premis:
(Nota: Sila tanda (√) mana-mana yang berkenaan)
Lot kedai
Kampus dibina khas
Kompleks beli belah
Kediaman
Lot pejabat
Lain-lain (sila nyatakan):
_________________________________________________________________________________
2.
Pemunyaan premis:
(Nota: Sila tanda (√) mana-mana yang berkenaan)
Premis kepunyaan sendiri
Harga belian premis (jika berkenaan):
__________________________________________________________________________________________
Premis sewa
Amaun sewa: RM ____________________________*sebulan/setahun
Tarikh habis tempoh sewa: _________________________________________________
P.U. (A) 53 19
Nama pemunya premis: _________________________________________________
_________________________________________________
Alamat:
_________________________________________________
_________________________________________________
Poskod:
_________________________________________________
Daerah:
_________________________________________________
Negeri:
_________________________________________________
3.
Luas lantai premis: ___________________________________*meter persegi/kaki persegi
Luas tapak premis: ____________________________________________________ *hektar/ekar
(Nota: *Potong mana-mana yang tidak berkenaan)
4.
Butir-butir bangunan:
Bil.
Nama bangunan
Jenis kegunaan
Jumlah bilangan bilik
5.
Butir-butir kemudahan rekreasi:
Bil.
Jenis kemudahan rekreasi
Jumlah bilangan kemudahan rekreasi
P.U. (A) 53 20
6.
Butir-butir kemudahan lain:
Bil.
Jenis kemudahan
Jumlah bilangan kemudahan
BAHAGIAN VIII
KETUA EKSEKUTIF YANG DICADANGKAN
1.
Nama penuh:___________________________________________________________________________
(Huruf Besar)
2.
*No. K.P./No. Pasport: ___________________________________________________________
(Nota: *Potong mana-mana yang tidak berkenaan)
3.
Kewarganegaraan: ___________________________________________________________
4.
Maklumat mengenai pekerjaan semasa (jika ada):
Jawatan:
___________________________________________________________
Nama majikan:
___________________________________________________________
Gambar ukuran pasport
P.U. (A) 53 21
Alamat majikan: ___________________________________________________________
___________________________________________________________
Poskod:
___________________________________________________________
Daerah: ___________________________________________________________
Negeri:
___________________________________________________________
No. Telefon: ___________________________________________________________
No. Faks: ___________________________________________________________
E-mel:
___________________________________________________________
5.
Kelayakan akademik tertinggi atau kelayakan profesional:
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
6.
Pengalaman pekerjaan:
Bil.
Nama dan alamat organisasi
Tahun
Jawatan
Dari
Hingga
P.U. (A) 53 22
BAHAGIAN IX
AKUAN
Saya, __________________________________________________________________________________________
*No. K.P./No. Pasport _______________________________________________________________________
bagi pihak ____________________________________________________________________________________
(nama syarikat) dengan sesungguhnya mengaku bahawa—
pernyataan yang terkandung dalam permohonan ini dan dokumen yang dilampirkan adalah benar sepanjang pengetahuan dan kepercayaan saya, dan jika pernyataan dan dokumen itu didapati palsu atau mengelirukan,
Ketua Pendaftar mempunyai hak untuk mengambil apa-apa tindakan yang perlu sebagaimana yang diperuntukkan di bawah Akta;
(b)
sepanjang pengetahuan saya, semua anggota pengurusan syarikat termasuk mana-mana pengarah, pengurus, setiausaha atau mana-mana orang yang memegang jawatan seumpamanya yang lain dalam syarikat tidak mempunyai sabitan jenayah; dan
(c)
sepanjang pengetahuan saya, semua anggota pengurusan syarikat tidak diisytiharkan sebagai bankrap.
Ditandatangani dan diakui oleh,
Cap Rasmi
___________________________________
_______________________________
(Tandatangan)
(Tarikh)
Nama Penuh:
_______________________________________________________________________
*No. K.P./No. Pasport: _______________________________________________________________________
Jawatan:
_______________________________________________________________________
(Nota: *Potong mana-mana yang tidak berkenaan)
P.U. (A) 53 23
BORANG B
PERMOHONAN BAGI KELULUSAN UNTUK MENUBUHKAN CAWANGAN INSTITUSI
PENDIDIKAN TINGGI SWASTA
Ketua Pendaftar Institusi Pendidikan Tinggi Swasta,
Saya memohon bagi penubuhan suatu cawangan—
(Nota: Sila tanda (√) mana-mana yang berkenaan)
Universiti
Kolej Universiti
Kolej
Nota:
BAHAGIAN II – Untuk diisi oleh syarikat berhad menurut syer
BAHAGIAN III –Untuk diisi oleh syarikat berhad menurut jaminan
P.U. (A) 53 24
BAHAGIAN I
BUTIR-BUTIR INSTITUSI PENDIDIKAN TINGGI SWASTA
1.
Nama institusi pendidikan tinggi swasta:
__________________________________________________________________________________________
2.
Jenis institusi pendidikan tinggi swasta:
(Nota: Sila tanda (√) mana-mana yang berkenaan)
Universiti
Kolej Universiti
Kolej
3.
Tarikh penubuhan: _____________________________________________________
4.
Tempoh kesahan pendaftaran: ____________________ hingga ________________________
5.
Alamat institusi pendidikan tinggi swasta:
____________________________________________________
____________________________________________________
Poskod:
____________________________________________________
Daerah:
____________________________________________________
Negeri:
____________________________________________________
6.
Penarafan kualiti kebangsaan terkini: _______________________________________________
P.U. (A) 53 25
7.
Perakuan kualiti pengajaran dan pembelajaran:
(Nota: Sila tanda (√) mana-mana yang berkenaan)
ISO
No. Perakuan:
_______________________________________
Sah sehingga: _______________________________________
Lain-lain (sila nyatakan)
_______________________________________
No. Perakuan:
_______________________________________
Sah sehingga: _______________________________________
8.
Butir-butir pelajar:
Jumlah bilangan pelajar:
___________________
Jumlah bilangan pelajar antarabangsa:
___________________
Jumlah bilangan pelajar yang disediakan penginapan: ___________________
9.
Bilangan guru:
Bil.
Kelayakan tertinggi
Bilangan guru
Tetap
Sementara 1.
Ijazah kedoktoran
2.
Ijazah sarjana
3.
Ijazah sarjana muda
4.
Diploma
5.
Sijil
P.U. (A) 53 26
10. Lembaga pengelola:
11. Senarai kursus pengajian atau program latihan:
Bil.
Kursus pengajian/
Program latihan
Jenis kursus pengajian
Tempoh kesahan
Nombor rujukan perakuan
Tarikh perakuan
Tarikh kelulusan
Tarikh habis tempoh
12. Butir-butir bangunan:
Bil.
Nama bangunan
Jenis kegunaan
Jumlah bilangan bilik
Bil.
Nama penuh
Jawatan
Kelayakan tertinggi
Bilangan tahun pengalaman dalam institusi pendidikan tinggi
P.U. (A) 53 27
13. Butir-butir kemudahan rekreasi:
Bil.
Jenis kemudahan rekreasi
Jumlah bilangan kemudahan rekreasi
14. Butir-butir kemudahan lain:
Bil.
Jenis kemudahan
Jumlah bilangan kemudahan
15. Bantuan kewangan pelajar:
(Nota: Sila tanda (√) mana-mana yang berkenaan)
Bil.
Jenis bantuan kewangan pelajar
Ya
Tidak 1.
Tabung Pendidikan Tinggi Nasional
2.
Bantuan kewangan dalaman institusi
3.
Biasiswa Kerajaan
4.
Lain-lain (sila nyatakan)
P.U. (A) 53 28
16. Pengurusan pelajar antarabangsa:
(Nota: Sila tanda (√) mana-mana yang berkenaan)
Wujudnya pejabat pelajar antarabangsa
Ya Tidak
Wujudnya pegawai perhubungan pelajar antarabangsa
Ya Tidak
Wujudnya sistem atau prosedur bagi pelajar antarabangsa
Ya Tidak
BAHAGIAN II
BUTIR-BUTIR SYARIKAT
(SYARIKAT BERHAD MENURUT SYER)
1.
Nama syarikat:
________________________________________________________
________________________________________________________
2.
Status syarikat:
(Nota: Sila tanda (√) mana-mana yang berkenaan)
Syarikat awam
Syarikat persendirian
3.
No. Pendaftaran Syarikat:
______________________________________________
4.
Tarikh pendaftaran:
______________________________________________
P.U. (A) 53 29
5.
Alamat berdaftar syarikat:
______________________________________________
______________________________________________
Poskod:
______________________________________________
Daerah:
______________________________________________
Negeri:
______________________________________________
No. Telefon:
______________________________________________
No. Faks:
______________________________________________
E-mel:
______________________________________________
6.
Alamat surat-menyurat syarikat: ______________________________________________
______________________________________________
Poskod:
______________________________________________
Daerah:
______________________________________________
Negeri:
______________________________________________
No. Telefon:
______________________________________________
No. Faks:
______________________________________________
E-mel:
______________________________________________
7.
Modal terbitan:
RM ______________________________________________
8.
Modal berbayar:
RM ______________________________________________
P.U. (A) 53 30
9.
Pemegang saham:
Bil.
Jenis pemegang saham
(Individu/Syarikat awam/Syarikat persendirian)
Nama penuh dan No. K.P./
No. Pasport atau
Nama syarikat dan No.
Pendaftaran Syarikat
Kewarganegaraan
(jika berkenaan)
Bangsa
(jika berkenaan)
Saham
Nilai
Peratusan
%
Jumlah
(Nota: Jika pemegang saham terdiri daripada suatu syarikat, sila berikan butir-butir terkini semua pemegang saham syarikat itu)
10.
Lembaga pengarah:
Bil.
Nama penuh dan
No. K.P./
No. Pasport
Kewarganegaraan
Bangsa Profesion
Jawatan dalam syarikat
11.
Kelulusan lain yang telah diberikan kepada pemohon di bawah Akta:
Bil.
Jenis kelulusan
Tarikh kelulusan
No. Rujukan
Catatan
12.
Kepentingan kewangan pemohon dalam perniagaan mana-mana orang atau syarikat lain yang mengadakan atau menguruskan institusi pendidikan tinggi di dalam atau di luar Malaysia:
Bil.
Nama orang/syarikat
(yang mengadakan atau menguruskan institusi pendidikan tinggi)
Nama institusi pendidikan tinggi
Jenis kepentingan kewangan
Nilai
Jumlah
31
P.U. (A) 53 32
13.
Kepentingan atau hak orang lain dalam perniagaan pemohon termasuk hak untuk menamakan mana-mana pengarah bagi syarikat pemohon:
Bil.
Nama orang/syarikat
(yang mempunyai kepentingan atau hak)
Jenis kepentingan/
hak
Nilai
Jumlah
14.
Urusan perniagaan lain pemohon:
Bil.
Jenis perniagaan
Nama syarikat/
organisasi perniagaan
Jenis penglibatan/
Jawatan
P.U. (A) 53 33
15.
Kepentingan kewangan atau hak orang lain dalam urusan perniagaan lain pemohon:
Bil.
Jenis perniagaan
Nama syarikat/
organisasi perniagaan
Nama orang/
syarikat
(yang mempunyai kepentingan kewangan atau hak)
Jenis kepentingan kewangan/
hak
Nilai
Jumlah
BAHAGIAN III
BUTIR-BUTIR SYARIKAT
(SYARIKAT BERHAD MENURUT JAMINAN)
1.
Nama syarikat:
________________________________________________
________________________________________________
2.
No. Pendaftaran Syarikat: ________________________________________________
3.
Tarikh pendaftaran:
________________________________________________
4.
Alamat berdaftar syarikat:
________________________________________________
________________________________________________
Poskod:
________________________________________________
Daerah:
________________________________________________
Negeri:
_______________________________________________
P.U. (A) 53 34
No. Telefon:
_______________________________________________
No. Faks:
_______________________________________________
E-mel:
_______________________________________________
5.
Alamat surat-menyurat syarikat: _______________________________________________
_______________________________________________
Poskod:
_______________________________________________
Daerah:
_______________________________________________
Negeri:
_______________________________________________
No. Telefon:
_______________________________________________
No. Faks:
_______________________________________________
E-mel:
_______________________________________________
6.
Anggota:
Bil.
Nama penuh dan No. K.P./
No. Pasport atau
Nama syarikat dan No.
Pendaftaran Syarikat
Alamat tetap/Alamat berdaftar syarikat
Sumbangan
Jumlah
P.U. (A) 53 35
7.
Lembaga pengarah atau pemegang amanah:
Bil.
Nama penuh dan
No. K.P./No. Pasport
Kewarganegaraan
Bangsa Profesion
Jawatan dalam syarikat
8.
Kelulusan lain yang telah diberikan kepada pemohon di bawah Akta:
Bil.
Jenis kelulusan
Tarikh kelulusan
No. Rujukan
Catatan
9.
Kepentingan kewangan pemohon dalam perniagaan mana-mana orang atau syarikat lain yang mengadakan atau menguruskan institusi pendidikan tinggi di dalam atau di luar Malaysia:
Bil.
Nama orang/syarikat
(yang mengadakan atau menguruskan institusi pendidikan tinggi)
Nama institusi pendidikan tinggi
Jenis kepentingan kewangan
Nilai
Jumlah
P.U. (A) 53 36
10.
Kepentingan atau hak orang lain dalam perniagaan pemohon termasuk hak untuk menamakan mana-mana pengarah bagi syarikat pemohon:
Bil.
Nama orang/syarikat
(yang mempunyai kepentingan atau hak)
Jenis kepentingan/
hak
Nilai
Jumlah
11.
Urusan perniagaan lain pemohon:
Bil.
Jenis perniagaan
Nama syarikat/
organisasi perniagaan
Jenis penglibatan/
Jawatan
12.
Kepentingan kewangan atau hak orang lain dalam urusan perniagaan lain pemohon:
Bil.
Jenis perniagaan
Nama syarikat/
organisasi perniagaan
Nama orang/syarikat
(yang mempunyai kepentingan atau hak)
Jenis kepentingan kewangan/
hak
Nilai
Jumlah
P.U. (A) 53 37
BAHAGIAN IV
BUTIR-BUTIR CAWANGAN INSTITUSI PENDIDIKAN TINGGI SWASTA
YANG DICADANGKAN
1.
Nama cawangan yang dicadangkan:
Bil.
Bahasa kebangsaan
Bahasa Inggeris
2.
Alamat cawangan yang dicadangkan: _____________________________________________
_____________________________________________
Poskod: _____________________________________________
Daerah:
_____________________________________________
Negeri:
_____________________________________________
3.
Jurusan kursus yang ditawarkan:
____________________________________________
____________________________________________
4.
Cawangan sedia ada (jika ada):
Bil.
Nama cawangan
Alamat
Jurusan kursus yang ditawarkan
P.U. (A) 53 38
BAHAGIAN V
KURSUS PENGAJIAN DAN PROGRAM LATIHAN YANG DICADANGKAN
Bil.
Nama kursus pengajian/
program latihan
Bidang
Peringkat
Jenis kursus pengajian
Cara penyampaian
Tempoh kursus
Kelayakan kemasukan
Rakan kongsi kerjasama
(jika berkenaan)
Badan atau institusi yang menganugerahkan
Tahunan
Kursus keseluruhan
39
BAHAGIAN VI
UNJURAN BILANGAN PELAJAR DAN GURU
Bil.
Nama kursus pengajian/Program latihan
Bidang
Unjuran bilangan pelajar dan guru
(bagi perancangan lima tahun selepas pendaftaran)
Tahun 1
Tahun 2
Tahun 3
Tahun 4
Tahun 5
Jumlah
(Nota: P: Pelajar, G: Guru)
BAHAGIAN VII
SUMBER KEWANGAN
Bil.
Sumber
Amaun (RM)
Jumlah
40
BAHAGIAN VIII
PREMIS DAN KEMUDAHAN
1.
Jenis premis:
(Nota: Sila tanda (√) mana-mana yang berkenaan)
Lot kedai
Kampus yang dibina
Kompleks beli belah
Kediaman
Lot pejabat
Lain-lain (sila nyatakan):
________________________________________________________________________________
2.
Pemunyaan premis:
(Nota: Sila tanda (√) mana-mana yang berkenaan)
Premis kepunyaan sendiri
Harga belian premis (jika berkenaan):
__________________________________________________________________________________________
Premis sewa
Amaun sewa: RM ________________________________________________ *sebulan/setahun
Tarikh habis tempoh sewa: _________________________________________________
41
Nama pemunya premis: _________________________________________________
Alamat:
_________________________________________________
_________________________________________________
Poskod:
_________________________________________________
Daerah:
_________________________________________________
Negeri:
_________________________________________________
3.
Luas lantai premis: ___________________________________*meter persegi/kaki persegi
Luas tapak premis: ____________________________________________________ *hektar/ekar
(Nota: *Potong mana-mana yang tidak berkenaan)
4.
Butir-butir bangunan:
Bil.
Nama bangunan
Jenis kegunaan
Jumlah bilangan bilik
5.
Butir-butir kemudahan rekreasi:
Bil.
Jenis kemudahan rekreasi
Jumlah bilangan kemudahan rekreasi
42
6.
Butir-butir kemudahan lain:
Bil.
Jenis kemudahan
Jumlah bilangan kemudahan
BAHAGIAN IX
KETUA CAWANGAN YANG DICADANGKAN
1.
Nama penuh: __________________________________________________________________________
(Huruf Besar)
2.
*No. K.P./No. Pasport: ___________________________________________________________
(Nota: *Potong mana-mana yang tidak berkenaan)
3.
Kewarganegaraan: ___________________________________________________________
4.
Maklumat mengenai pekerjaan semasa (jika ada):
Jawatan:
___________________________________________________________
Nama majikan:
___________________________________________________________
Gambar ukuran pasport
43
Alamat majikan: __________________________________________________________
__________________________________________________________
Poskod:
__________________________________________________________
Daerah: __________________________________________________________
Negeri:
__________________________________________________________
No. Telefon: __________________________________________________________
No. Faks: __________________________________________________________
E-mel:
__________________________________________________________
5.
Kelayakan akademik tertinggi atau kelayakan profesional:
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
6.
Pengalaman pekerjaan:
Bil.
Nama dan alamat organisasi
Tahun
Jawatan
Dari
Hingga
44
BAHAGIAN X
AKUAN
Saya, __________________________________________________________________________________________
*No. K.P./No. Pasport _______________________________________________________________________
Ketua Eksekutif______________________________________________________________________________
(nama institusi pendidikan tinggi swasta) dengan sesungguhnya mengaku bahawa—
pernyataan yang terkandung dalam permohonan ini dan dokumen yang dilampirkan adalah benar sepanjang pengetahuan dan kepercayaan saya, dan jika pernyataan dan dokumen itu didapati palsu atau mengelirukan,
Ketua Pendaftar mempunyai hak untuk mengambil apa-apa tindakan yang perlu sebagaimana yang diperuntukkan di bawah Akta;
(b)
sepanjang pengetahuan saya, semua anggota pengurusan syarikat termasuk mana-mana pengarah, pengurus, setiausaha atau mana-mana orang yang memegang jawatan seumpamanya yang lain dalam syarikat, serta semua kakitangan dan guru institusi pendidikan tinggi swasta tidak mempunyai sabitan jenayah; dan
(c)
sepanjang pengetahuan saya, semua anggota pengurusan syarikat tidak diisytiharkan sebagai bankrap.
Ditandatangani dan diakui oleh,
Cap Rasmi
___________________________________
_______________________________
(Tandatangan)
(Tarikh)
Nama Penuh:
_______________________________________________________________________
*No. K.P./No. Pasport: _______________________________________________________________________
45
(Nota: *Potong mana-mana yang tidak berkenaan)
JADUAL KEDUA
[Subperaturan 2(2) dan 5(2)]
FI
Bil.
Perkara
1.
Permohonan bagi kelulusan untuk menubuhkan:
(a)
Universiti 2000.00
(b)
Kolej Universiti 2000.00
(c)
Kampus cawangan luar negeri 2000.00
(d)
Kolej 500.00
2.
Permohonan bagi kelulusan untuk menubuhkan suatu cawangan:
(a)
Universiti 2000.00
(b)
Kolej Universiti 2000.00
(c)
Kolej 500.00
Dibuat 19 Februari 2018
[KPT.U.(S)100-1/2/2/Jld.7; PN(PU2)685]
DATO' SERI IDRIS BIN JUSOH
Menteri Pendidikan Tinggi
46
PRIVATE HIGHER EDUCATIONAL INSTITUTIONS ACT 1996
IN exercise of the powers conferred by section 88
of the
Private Higher Educational Institutions Act 1996 [Act 555], the Minister makes the following regulations:
Citation and commencement 1.
(1)
These regulations may be cited as the Private Higher Educational
Institutions (Establishment of Private Higher Educational Institution and
Branch) Regulations 2018.
These Regulations come into operation on 23 February 2018.
Application for approval to establish private higher educational institution 2.
(1)
An application for approval to establish a private higher educational institution under section 6 of the Act shall be made by an applicant to the
Registrar General in Form A as specified in the First Schedule.
(2)
The application under subregulation (1) shall be accompanied by—
(a)
any document as determined by the Registrar General; and
(b)
the fee as specified in the Second Schedule.
(3)
The fee referred to in paragraph (2)(b) shall be payable to the
Registrar General.
47
Prescribed requirements 3.
For the purpose of paragraph 9(c) of the Act, the prescribed requirements are as follows:
(a)
the applicant is capable of providing the site and premises for the use of the private higher educational institution;
(b)
the applicant has an appropriate experience or excellent performance record in education;
(c)
the applicant is capable of providing qualified and experienced teachers in the relevant fields for the private higher educational institution;
(d)
the applicant has a strong financial position and is capable of providing good financial management for the private higher educational institution;
and
(e)
the applicant is capable of conducting courses of study or training programmes individually or in affiliation, association or collaboration with any higher educational institutions or professional bodies.
Issued and paid up capital or initial fund of company 4.
(1)
For the purpose of paragraph 12(1)(a) of the Act, the issued and paid up capital of the applicant shall not be less than one million ringgit.
(2)
For the purpose of paragraph 12(1A)(a) of the Act, the initial fund of the applicant shall not be less than one million ringgit.
48
Application for approval to establish branch 5.
(1)
An application for approval to establish a branch under section 18 of the Act shall be made by a private higher educational institution to the
Registrar General in Form B as specified in the First Schedule.
(2)
The application under subregulation (1) shall be accompanied by—
(a)
any document as determined by the Registrar General; and
(b)
the fee as specified in the Second Schedule.
(3)
The fee referred to in paragraph (2)(b) shall be payable to the
Registrar General.
Amendment of certificate of registration 6.
The private higher educational institution shall submit the certificate of registration issued under subsection 24(9) of the Act to the Registrar General for amendment within three years from the date of approval to establish a branch under paragraph 18(6)(a) of the Act.
Revocation 7.
The Private Higher Educational Institutions (Establishment) Regulations 1997
[P.U. (A) 539/1997] are revoked.
Savings 8.
All applications made under the
Private
Higher
Educational
Institutions (Establishment) Regulations 1997, which are referred to as the
“revoked Regulations” under this regulation, which are pending immediately before the date of coming into operation of these Regulations shall, on the date of coming into operation of these Regulations, be dealt with under the revoked Regulations as if these Regulations have not been made.
49
FIRST SCHEDULE
[Regulations 2 and 5]
FORM A
APPLICATION FOR APPROVAL TO ESTABLISH PRIVATE HIGHER
Registrar General of Private Higher Educational Institutions,
I seek to apply for the establishment of—
(Note: Please tick (√) whichever is applicable)
University
University College
Foreign branch campus
College
Note:
PART I - To be filled in by a company limited by shares
PART II - To be filled in by a company limited by guarantee
50
PART I
PARTICULARS OF APPLICANT
(COMPANY LIMITED BY SHARES)
1.
Name of company:
__________________________________________________
__________________________________________________
2.
Status of company:
(Note: Please tick (√) whichever is applicable)
Public company
Private company
3.
Company Registration No.: ____________________________________________________
4.
Date of registration:
____________________________________________________
5.
Registered address of company: ____________________________________________________
____________________________________________________
Postcode:
____________________________________________________
District:
____________________________________________________
State:
____________________________________________________
Telephone No.:
____________________________________________________
Fax No.:
____________________________________________________
E-mail:
____________________________________________________
51
6.
Correspondence address of company: ______________________________________________
______________________________________________
Postcode:
______________________________________________
District:
______________________________________________
State:
______________________________________________
Telephone No.:
______________________________________________
Fax No.:
______________________________________________
E-mail:
______________________________________________
7.
Issued capital:
RM ______________________________________________
8.
Paid up capital:
RM ______________________________________________
52
9.
Shareholder:
Type of shareholder
(Individual/Public company/Private company)
Full name and I.C. No./
Passport No. or
Company name and
Company Registration No.
Citizenship
(if applicable)
Race
(if applicable)
Share
Value
Percentage
%
Total
(Note: If the shareholder comprises of a company, please provide the latest particulars of all shareholders of the company)
53
10. Board of directors:
Full name and
I.C. No./Passport No.
Citizenship
Race Profession
Designation in company
11. Other approval that has been granted to the applicant under the Act:
Type of approval
Date of approval
Reference No.
Remark
12. The applicant’s financial interest in the business of any other person or company that provides or manages a higher educational institution within or outside Malaysia:
Name of person/company
(that provides or manages higher educational institution)
Name of higher educational institution
Types of financial interest
Value
Total
54
13. Other person’s interests or rights in the applicant’s business including the right to nominate any director of the applicant’s company:
Name of person/company
(that has interest or right)
Type of interest/right
Value
Total
14. The applicant’s other business concerns:
Type of business
Name of company/business organization
Type of involvement/
Designation
55
15. Other person’s financial interests or rights in the applicant’s other business concerns:
Type of business
Name of company/
business organization
Name of person/
company
(that has financial interest or right)
Type of financial interest/right
Value
Total
PART II
PARTICULARS OF APPLICANT
(COMPANY LIMITED BY GUARANTEE)
1.
Name of company:
______________________________________________
______________________________________________
2.
Company Registration No.:
______________________________________________
3.
Date of registration:
______________________________________________
4.
Registered address of company:
______________________________________________
______________________________________________
Postcode:
______________________________________________
District:
______________________________________________
56
State:
______________________________________________
Telephone No.:
______________________________________________
Fax No.:
______________________________________________
E-mail:
______________________________________________
5.
Correspondence address of company: ______________________________________________
______________________________________________
Postcode:
______________________________________________
District:
______________________________________________
State:
______________________________________________
Telephone No.:
______________________________________________
Fax No.:
______________________________________________
E-mail:
______________________________________________
6.
Member:
Full name and I.C. No./
Passport No. or
Company name and
Company Registration No.
Permanent address/
Registered address of company
Contribution
Total
57
7.
Board of directors or trustee:
Full name and
I.C. No./Passport No.
Citizenship
Race Profession
Designation in company
8.
Other approval that has been granted to the applicant under the Act:
Type of approval
Date of approval
Reference No.
Remark
9.
The applicant’s financial interest in the business of any other person or company that provides or manages a higher educational institution within or outside Malaysia:
Name of person/company
(that provides or manages higher educational institution)
Name of higher educational institution
Types of financial interest
Value
Total
58
10. Other person’s interests or rights in the applicant’s business including the right to nominate any director of the applicant’s company:
Name of person/company
(that has interest or right)
Type of interest/right
Value
Total
11. The applicant’s other business concerns:
Type of business
Name of company/
business organization
Type of involvement/
Designation
12. Other person’s financial interests or rights in the applicant’s other business concerns:
Type of business
Name of company/
business organization
Name of person/
company
(that has financial interest or right)
Type of financial interest/right
Value
Total
59
PART III
PARTICULARS OF PROPOSED PRIVATE HIGHER EDUCATIONAL INSTITUTION
1.
Three proposed names of private higher educational institution:
National language
English language 1.
2.
3.
2.
Proposed address of private higher educational institution:
_____________________________________________________
_____________________________________________________
Postcode:
_____________________________________________________
District:
_____________________________________________________
State:
_____________________________________________________
60
PART IV
PROPOSED COURSE OF STUDY AND TRAINING PROGRAMME
Name of course of study/
training programme
Field Level
Type of course of study
Mode of delivery
Course duration
Entry qualifications
Collaborative partner
(if applicable)
Awarding body or institution
Yearly
Overall course
61
PART V
PROJECTED NUMBER OF STUDENTS AND TEACHERS
Name of course of study/
training programme
Field
Projected number of students and teachers
(for five year planning after registration)
Year 1
Year 2
Year 3
Year 4
Year 5
STSTSTSTST
Total
(Note: S: Student, T: Teacher)
PART VI
FINANCIAL SOURCES
Source
Amount (RM)
Total
P.U. (A) 53 62
PART VII
PREMISES AND FACILITIES
1.
Type of premises:
(Note: Please tick (√) whichever is applicable)
Shop lot
Purpose-built campus
Shopping complex
Residence
Office lot
Others (please specify):
________________________________________________________________________________
2.
Ownership of premises:
(Note: Please tick (√) whichever is applicable)
Self-owned premises
Purchase price of premises (if applicable):
__________________________________________________________________________________________
Rented premises
Rental amount: RM _____________________________per *month/year
Date of expiry of rental period: _________________________________________________
P.U. (A) 53 63
Name of owner of premises: _________________________________________________
_________________________________________________
Address:
_________________________________________________
_________________________________________________
Postcode:
_________________________________________________
District:
_________________________________________________
State:
_________________________________________________
3.
Floor area of premises: ________________________________ *square metre/square feet
Site area of premises: ________________________________________________ *hectare/acre
(Note: *Delete whichever is not applicable)
4.
Particulars of building:
Name of building
Type of use
Total number of rooms
5.
Particulars of recreational facilities:
Type of recreational facilities
Total number of recreational facilities
P.U. (A) 53 64
6.
Particulars of other facilities:
Type of facilities
Total number of the facilities
PART VIII
PROPOSED CHIEF EXECUTIVE
1.
Full name: _____________________________________________________________________________
(Capital Letters)
2.
*I.C. No./Passport No.: ___________________________________________________________
(Note: *Delete whichever is not applicable)
3.
Citizenship: ___________________________________________________________
4.
Information on current employment (if any):
Designation:
____________________________________________________________
Name of employer: ____________________________________________________________
Passport size photograph
P.U. (A) 53 65
Address of employer: ___________________________________________________________
___________________________________________________________
Postcode: ___________________________________________________________
District: ___________________________________________________________
State:
___________________________________________________________
Telephone No.: ___________________________________________________________
Fax No.: ___________________________________________________________
E-mail:
___________________________________________________________
5.
Highest academic qualification or professional qualification:
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
6.
Employment experience:
Name and address of organization
Year
Designation
From
To
P.U. (A) 53 66
PART IX
DECLARATION
I, ______________________________________________________________________________________________
*I.C. No./Passport No. _______________________________________________________________________
on behalf of __________________________________________________________________________________
(name of company) do solemnly declare that—
the statements contained in this application and enclosed documents are true to the best of my knowledge and belief, and if such statements and documents are found to be false or misleading, the Registrar General has the right to take any necessary action as provided under the Act;
(b)
to the best of my knowledge, all members of the management of the company including any director, manager, secretary or any person holding other similar designation in the company have no criminal conviction; and
(c)
to the best of my knowledge, all members of the management of the company are not declared as bankrupts.
Signed and declared by,
Official Stamp
___________________________________
________________________
(Signature)
(Date)
Full Name: ______________________________________________________________________
*I.C. No./Passport No.: ______________________________________________________________________
Designation:
______________________________________________________________________
(Note: *Delete whichever is not applicable)
P.U. (A) 53 67
FORM B
APPLICATION FOR APPROVAL TO ESTABLISH BRANCH OF PRIVATE HIGHER
Registrar General of Private Higher Educational Institutions,
I seek to apply for the establishment of a branch of—
(Note: Please tick (√) whichever is applicable)
University
University College
College
Note:
PART II - To be filled in by a company limited by shares
PART III - To be filled in by a company limited by guarantee
P.U. (A) 53 68
PART I
PARTICULARS OF PRIVATE HIGHER EDUCATIONAL INSTITUTION
1.
Name of private higher educational institution:
__________________________________________________________________________________________
2.
Type of private higher educational institution:
(Note: Please tick (√) whichever is applicable)
University
University College
College
3.
Date of establishment: _____________________________________________________
4.
Validity period of registration: ________________________ to _________________________
5.
Address of private higher educational institution:
_______________________________________________________
_______________________________________________________
Postcode:
_______________________________________________________
District:
_______________________________________________________
State:
_______________________________________________________
6.
Latest national quality rating: ________________________________________________________
P.U. (A) 53 69
7.
Teaching and learning quality certification:
(Note: Please tick (√) whichever is applicable)
ISO
Certification No.: _______________________________________
Valid until: _______________________________________
Others (please specify)
_______________________________________
Certification No.: _______________________________________
Valid until: _______________________________________
8.
Particulars of students:
Total number of students:
______________
Total number of international students:
______________
Total number of students who are provided with accommodation: ______________
9.
Number of teachers:
Highest qualification
Number of teachers
Permanent
Temporary 1.
Doctorate degree
2.
Master degree
3.
Bachelor degree
4.
Diploma
5.
Certificate
P.U. (A) 53 70
10.
Board of governance:
11.
List of course of study or training programme:
Course of study/
Training programme
Type of course of study
Validity period
Accreditation reference number
Accreditation date
Approval date
Expiry date
12.
Particulars of building:
Name of building
Type of use
Total number of rooms
Full Name
Designation
Highest qualification
Years of experience in higher education institution
P.U. (A) 53 71
13.
Particulars of recreational facilities:
Type of recreational facilities
Total number of recreational facilities
14.
Particulars of other facilities:
Type of facilities
Total number of facilities
15.
Student financial aid:
(Note: Please tick (√) whichever is applicable)
Type of student financial aid
Yes
No 1.
Tabung Pendidikan Tinggi Nasional
2.
Institution internal financial aids
3.
Government scholarship
4.
Others (please specify)
P.U. (A) 53 72
16.
International student management:
(Note: Please tick (√) whichever is applicable)
Existence of international student office
Yes No
Existence of international student liaison officer
Yes No
Existence of system or procedure for international students
Yes No
PART II
PARTICULARS OF COMPANY
(COMPANY LIMITED BY SHARES)
1.
Name of company:
______________________________________________
______________________________________________
2.
Status of company:
(Note: Please tick (√) whichever is applicable)
Public company
Private company
3.
Company Registration No.: ______________________________________________
4.
Date of registration:
______________________________________________
P.U. (A) 53 73
5.
Registered address of company: ______________________________________________
______________________________________________
Postcode:
______________________________________________
District:
______________________________________________
State:
______________________________________________
Telephone No.:
______________________________________________
Fax No.:
______________________________________________
E-mail:
______________________________________________
6.
Correspondence address of company: ______________________________________________
______________________________________________
Postcode:
______________________________________________
District:
______________________________________________
State:
______________________________________________
Telephone No.:
______________________________________________
Fax No.:
______________________________________________
E-mail:
______________________________________________
7.
Issued capital:
RM ______________________________________________
8.
Paid up capital:
RM ______________________________________________
P.U. (A) 53 74
9.
Shareholder:
Type of shareholder
(Individual/Public company/Private company)
Full name and I.C. No./
Passport No. or
Company name and
Company Registration No.
Citizenship
(if applicable)
Race
(if applicable)
Share
Value
Percentage
%
Total
(Note: If the shareholder comprises of a company, please provide the latest particulars of all shareholders of the company)
75
10. Board of directors:
Full name and
I.C. No./Passport No.
Citizenship
Race Profession
Designation in company
11. Other approval that has been granted to the applicant under the Act:
Type of approval
Date of approval
Reference No.
Remark
12. The applicant’s financial interest in the business of any other person or company that provides or manages a higher educational institution within or outside Malaysia:
Name of person/company
(that provides or manages higher educational institution)
Name of higher educational institution
Types of financial interest
Value
Total
76
13. Other person’s interests or rights in the applicant’s business including the right to nominate any director of the applicant’s company:
Name of person/company
(that has interest or right)
Type of interest/right
Value
Total
14. The applicant’s other business concerns:
Type of business
Name of company/business organization
Type of involvement/
Designation
77
15. Other person’s financial interests or rights in the applicant’s other business concerns:
Type of business
Name of company/
business organization
Name of person/
company
(that has financial interest or right)
Type of financial interest/right
Value
Total
PART III
PARTICULARS OF COMPANY
(COMPANY LIMITED BY GUARANTEE)
1.
Name of company:
______________________________________________
______________________________________________
2.
Company Registration No.:
______________________________________________
3.
Date of registration:
______________________________________________
4.
Registered address of company:
______________________________________________
______________________________________________
Postcode:
______________________________________________
District:
______________________________________________
78
State:
______________________________________________
Telephone No.:
______________________________________________
Fax No.:
______________________________________________
E-mail:
______________________________________________
5.
Correspondence address of company: ______________________________________________
______________________________________________
Postcode:
______________________________________________
District:
______________________________________________
State:
______________________________________________
Telephone No.:
______________________________________________
Fax No.:
______________________________________________
E-mail:
______________________________________________
6.
Member:
Full name and I.C. No./
Passport No. or
Company name and
Company Registration No.
Permanent address/
Registered address of company
Contribution
Total
79
7.
Board of directors or trustee:
Full name and
I.C. No./Passport No.
Citizenship
Race Profession
Designation in company
8.
Other approval that has been granted to the applicant under the Act:
Type of approval
Date of approval
Reference No.
Remark
9.
The applicant’s financial interest in the business of any other person or company that provides or manages a higher educational institution within or outside Malaysia:
Name of person/company
(that provides or manages higher educational institution)
Name of higher educational institution
Types of financial interest
Value
Total
80
10. Other person’s interests or rights in the applicant’s business including the right to nominate any director of the applicant’s company:
Name of person/company
(that has interest or right)
Type of interest/right
Value
Total
11. The applicant’s other business concerns:
Type of business
Name of company/business organization
Type of involvement/
Designation
12. Other person’s financial interests or rights in the applicant’s other business concerns:
Type of business
Name of company/
business organization
Name of person/
company
(that has interest or right)
Type of financial interest/right
Value
Total
81
PART IV
PARTICULARS OF PROPOSED BRANCH OF PRIVATE HIGHER
1.
Proposed name of branch:
National language
English language
2.
Proposed address of branch:
____________________________________________
____________________________________________
Postcode:
____________________________________________
District:
____________________________________________
State:
____________________________________________
3.
Niche of course offered:
____________________________________________
____________________________________________
4.
Existing branch (if any):
Name of branch
Address
Niche of course offered
82
PART V
PROPOSED COURSE OF STUDY AND TRAINING PROGRAMME
Name of course of study/
training programme
Field Level
Type of course of study
Mode of delivery
Course duration
Entry qualifications
Collaborative partner
(if applicable)
Awarding body or institution
Yearly
Overall course
P.U. (A) 53 83
PART VI
PROJECTED NUMBER OF STUDENTS AND TEACHERS
Name of course of study/
Training programme
Field
Projected number of students and teachers
(for five year planning after registration)
Year 1
Year 2
Year 3
Year 4
Year 5
STSTSTSTST
Total
(Note: S: Student, T: Teacher)
PART VII
FINANCIAL SOURCES
Source
Amount (RM)
Total
P.U. (A) 53 84
PART VIII
PREMISES AND FACILITIES
1.
Type of premises:
(Note: Please tick (√) whichever is applicable)
Shop lot
Purpose-built campus
Shopping complex
Residence
Office lot
Others (please specify):
________________________________________________________________________________
2.
Ownership of premises:
(Note: Please tick (√) whichever is applicable)
Self-owned premises
Purchase price of premises (if applicable):
__________________________________________________________________________________________
Rented premises
Rental amount: RM ______________________________________________ per *month/year
Date of expiry of rental period: _________________________________________________
Name of owner of premises: _________________________________________________
P.U. (A) 53 85
Address:
_________________________________________________
_________________________________________________
Postcode:
_________________________________________________
District:
_________________________________________________
State:
_________________________________________________
3.
Floor area of premises: ________________________________ *square metre/square feet
Site area of premises: ________________________________________________ *hectare/acre
(Note: *Delete whichever is not applicable)
4.
Particulars of building:
Name of building
Type of use
Total number of rooms
5.
Particulars of recreational facilities:
Type of recreational facilities
Total number of recreational facilities
P.U. (A) 53 86
6.
Particulars of other facilities:
Type of facilities
Total number of facilities
PART IX
PROPOSED HEAD OF BRANCH
1.
Full name: ____________________________________________________________________________
(Capital Letters)
2.
*I.C. No./Passport No.: ____________________________________________________________
(Note: *Delete whichever is not applicable)
3.
Citizenship: ____________________________________________________________
4.
Information on current employment (if any):
Designation:
____________________________________________________________
Name of employer: ____________________________________________________________
Passport size photograph
P.U. (A) 53 87
Address of employer: ______________________________________________________________
______________________________________________________________
Postcode: ______________________________________________________________
District: ______________________________________________________________
State:
______________________________________________________________
Telephone No.: ______________________________________________________________
Fax No.: ______________________________________________________________
E-mail:
______________________________________________________________
5.
Highest academic qualification or professional qualification:
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
6.
Employment experience:
Name and address of organization
Year
Designation
From
To
P.U. (A) 53 88
PART X
DECLARATION
I, ____________________________________________________________________________________________________
*I.C. No./Passport No. ____________________________________________________________________________
Chief Executive of _________________________________________________________________________________
(name of private higher educational institution) do solemnly declare that—
the statements contained in this application and enclosed documents are true to the best of my knowledge and belief, and if such statements and documents are found to be false or misleading, the Registrar General has the right to take any necessary action as provided under the Act;
(b)
to the best of my knowledge, all members of the management of the company including any director, manager, secretary or any person holding other similar designation in the company, as well as all staff and teachers of the private higher educational institution have no criminal conviction; and
(c)
to the best of my knowledge, all members of the management of the company are not declared as bankrupts.
Signed and declared by,
Official Stamp
___________________________________
________________________
(Signature)
(Date)
Full Name: ___________________________________________________________________________
*I.C. No./Passport No.: ___________________________________________________________________________
(Note: *Delete whichever is not applicable)
P.U. (A) 53 89
SECOND SCHEDULE
[Subregulations 2(2) and 5(2)]
FEES
Matter
1.
Application for approval to establish:
(a)
University 2000.00
(b)
University College 2000.00
(c)
Foreign branch campus 2000.00
(d)
College 500.00
2.
Application for approval to establish a branch of:
(a)
University 2000.00
(b)
University College 2000.00
(c)
College 500.00
Made 19 February 2018
[KPT.U.(S)100-1/2/2/Jld.7; PN(PU2)685]
DATO' SERI IDRIS BIN JUSOH
Minister of Higher Education