Online Application Form

Major Selection

Choose your Major *

Please enter your desired major

Concentration (max 2) *

Pick your intended area of concentration (maximum 2 selection allowed)

Program Selection *

Personal Information

Full Name *

First

Last

Date of Birth *//

Please enter your date of birth

Place of Birth *

Please enter the city where you were born

Religion *

Please enter your religion - while we value your privacy, we are legally required to register students' religion.

Residential Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Mobile Phone *

Please enter your mobile phone number where we can reach you

Email Address *

Please enter your email address where we send your registration confirmation

Guardian Information

Guardian's Name *

First

Last

Please enter your parent's or guardian's name

Relationship to You *

Please enter your guardian's relationship to you

Guardian's Occupation *

Please enter your parent's / guardian's occupation

Do you live in the same household as your guardian? *

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Guardian's Mobile Phone *

Guardia's Email Address *

Guardian's Level of Income *

Less than IDR 10.000.000,- / month
More than IDR 10.000.000,-/ month

Formal Education Information

High School You Attended *

Please enter the full name of the high school you attended

High School Graduation Year *

Please enter the year which you graduated from high school

High School Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Have you previously attended any college or university? *

If yes, please enter your college below

Online Application Form

Major Selection

Personal Information

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Formal Education Information

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