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Online Application : ICSA International Qualification (ICSA IQS) (Page 1 of 7)  print
The online form will prompt you to seven (7) pages
Please use these forms to provide MAICSA with information to support your application
Please use the EDIT button at the bottom of the screen to key in the information
When you have completed the forms, please use the PRINT button at the bottom of the screen to print out the information that you have keyed in or click on the SAVE button at the bottom of the screen to save the data
The saved data will be purged from the MAICSA Interactive after one (1) month
Click on the SAVE button and NEXT button at the bottom of the screen to continue next page
Students are required to submit the hardcopies (page 1-4) of the application form together with the supporting documents, within one (1) month to the Institute, failing which, the submission will be invalid.
Reference No.:
The Malaysian Institute of Chartered Secretaries and Administrators (MAICSA)
Bangunan MAICSA, No. 57, The Boulevard, Mid Valley City, Lingkaran Syed Putra,
59200 Kuala Lumpur.
Tel: +(603) 2282 9276 Fax: +(603) 2282 9281
E-mail: students@maicsa.org.my Homepage: www.maicsa.org.my
Please tick () the programme you wish to enter at
Professional Diploma In Corporate Administration (PDCA) MAICSA PDCA Collaborative Scheme
ICSA International Qualifying Scheme (IQS) MAICSA Collaborative Masters Programmes
Please complete all sections of the form in block capitals and in black ink.
(as per Identification Card)
Other Names  Gender  Marital Status
(single / married / other)
Title  Honours
(Mr, Ms, Mrs, Dato', Datin or please specify other) (FCCA, FCMA, ACCA, ACMA or please specify other)
Date of Birth  Nationality  Race  Religion
New IC No Old IC NO
Residential Address (permanent address)
Town  Postcode  State  Country
Mailing Address (for MAICSA correspondence if different from the above)
Town  Postcode  State  Country
Telephone  Mobile  Email
Are you currently in full time employment? Yes No
Name of Company
Job Title Date Joined
Company Address
Town  Postcode  State  Country
Telephone  Ext  Fax No
Email Address Type of Organisation
Can we provide your employer with details of the ICSA programme? Yes No
If yes, please confirm the name and job title of the individual you wish us to contact
Name Job Title
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