Malaysian Qualification Agency (MQA)

PART 1 :PERSONAL DETAILS
Full Name
Nationality
NIRC/Passport No.
Intended Field Of Study
Intended Programme Total Graduation Credits
Name of Intended Higher Education Provider (HEP)
Number of Micro-Credentials (Courses) From the Accredited Programme
Percentage of Credits Accumulated (number of credits accumulated/total credits in th programme)
Leave Of Study Certificate Diploma Bachelor Master Doctorate
Reference Number

 

Malaysian Qualification Agency (MQA)
PART 2 : DETAILS OF LEARNING ACQUIRED (start with the most recent)
a) FORMAL LEARNING
International learning/ programme of study acquired in a structured context (promary school, secondary school, college or university) that led to a formal recognition / a recognised academic qualification.
NO. ACADEMIC QUALIFICATION AWARDING BODY/INSTITUTION YEAR AWARDED COMPETENCIES
( Please tick ✔ )
( Please refer Appendix 2 for list of skills on what I have learnt )		 EVIDENCE OF LEARNING*
( Please refer Appendix 1 for examples of evidence )
1 2 3 4 5 6 7 8
1. DIPLOMA KOLEJ VOKASIONAL (ERT) AZIZAH
2020
 ✔ ✔ ✔ ✔ ✔
2. Certificate Stanford College
1993
 ✔
3. Apel T6 Stamford College
1970
4. Master of Science Master of Science (Research)
2025
 ✔ ✔ ✔ ✔ ✔
5. 3. 86 ALAM maritime academy
2010
 ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔
6.
1970

 

 

Malaysian Qualification Agency (MQA)
b) INFORMAL LEARNING (start with the most recent)
Learning which takes place continuosly through life and work experiences. It is often unintentional learning
NO. NAME OF EMPLOYER/SELF-EMPLOYED CONTACT ADDRESS DURATION
MONTH/YEAR		 POSITION HELD WHAT I HAVE LEARNT / ACQUIRED
( Please tick ✔ )
( Please refer Appendix 2 for list of skills you have acquired )		 EVIDENCE OF LEARNING*
( Please refer Appendix 1 for examples of evidence )
FROM TO 1 2 3 4 5 6 7 8
1. Anwarul Mahabbah Care Center No 12 Jalan Kasawari Larkin Jaya 80350 Johor Bahru Johor
09-2020
 Present Elderly Caregiver ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔
2. Anwarul Mahabbah Care Center No 12 Jalan Kasawari Larkin Jaya 80350 Johor Bahru Johor
09-2020
 Present Assistant Operations Officer ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔
3. Chemopharm Sdn Bhd 20, Jalan SS2/66, 47300 Petaling Jaya, Selangor
01-1970
 01-1970 Project Manager ✔ ✔ ✔ ✔ ✔
4. Chemopharm Sdn Bhd 20, Jalan SS2/66, 47300 Petaling Jaya, Selangor
01-1970
 01-1970 Sr Project Manager ✔ ✔ ✔ ✔ ✔
5. Thermo Fisher Sdn Bhd 3, Jalan Sepadu 25/123, Taman Perindustrian Axis, 40400 Shah Alam, Selangor
01-1970
 01-1970 Sales Executive ✔ ✔
6. MY FOTO STUDIO H25, V BLOCK, KK2, UMPSA GAMBANG
01-1970
 01-1970 Professional Photographer ✔ ✔ ✔ ✔
7. EAGLESTAR shipmanagement Menara Dayabumi Jalan Sultan Hishamuddin 50050 Kuala Lumpur , Malaysia.
01-1970
 01-1970 Chief officer ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔

 

 

Malaysian Qualification Agency (MQA)
OTHER LEARNING ACTIVITIES
This may include your hobbies/ sports/ recreation/ social activities/ community service/ training given/consultancy services or other activities which might be relevant to the competencies		 YEAR WHAT I HAVE LEARNT/ ACQUIRED
( Please tick ✔ )
( Please refer Appendix 2 for list of skills you have acquired )		 EVIDENCE OF LEARNING*
( Please refer Appendix 1 for examples of evidence )
1 2 3 4 5 6 7 8

 

 

Malaysian Qualification Agency (MQA)
c) NON-FORMAL LEARNING (start with the most recent)
Learning that takes alongside the mainstream systems of education. It may be assesed but does not normally lead to formal certification. majority of the information here will comprise the Micro-Credentials that learners have acquired.
Part I: Micro-Credential from the accredited programme
NO. NAME OF MICRO-CREDENTIALS ORIGIN OF PROGRAMME
(with MQA reference number)		 INSTITUTIONS DATE AWARDED CREDITS HOURS GRADE WHAT I HAVE LEARNT / ACQUIRED
( Please tick ✔ )
( Please refer Appendix 1 for list of skills you have acquired )		 EVIDENCE OF LEARNING*
( Digital Badges/Micro-credential Malaysian Statement, MMS)
1 2 3 4 5 6 7 8
1.
2.
3.
4.
5.
6.
7.

 

 

Malaysian Qualification Agency (MQA)
Part II: Non-formal learning comprising short courses/workshops/ seminars/ conferences or training courses
NO. NAME/TITLE OF TRAINING/ COURSE etc. ORGANISER DATE OF COMPLETION LENGTH (Hours/Days/Month) GRADE
(if any)		 WHAT I HAVE LEARNT / ACQUIRED
( Please tick ✔ )
( Please refer Appendix 2 for list of skills you have acquired )		 EVIDENCE OF LEARNING*
(Please refer Appendix 1 for examples of evidences)
1 2 3 4 5 6 7 8
1.
2.
3.
4.
5.
6.
7.

 

 

Malaysian Qualification Agency (MQA)
d) LANGUAGE COMPETENCY
LANGUAGE LEVEL OF COMPETENCE ( Please tick ✔ )
1: POOR; 2: AVERAGE; 3: GOOD; 4: EXCELENT
LISTENING READING SPEAKING WRITING
1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4
1. BAHASA ENGLISH ✔ ✔ ✔ ✔
2. BAHASA MELAYU ✔ ✔ ✔ ✔

 

 

Malaysian Qualification Agency (MQA)


Describe how your prior learning experiences will prpepare you for the intended level of study (at least 500 words):
  1. Why do you want to pursue this intended programme of study after gathering the relevant credits through the Micro-Credential track?



  2. How many is your personal prior learning experience applicable to/related to/relevant to your chosen programme and level of study?
(You may provide your description based on how your prior experiential learning has improved your knowledge, skills set, professionalism, communication, leadership, problem solving etc).



  3. How will the completion of this programme help you in your life?



  4. What are your action in ensuring the succesful completion of your programme?
(Commitment, time management, financial resources and support etc)

 

 

Malaysian Qualification Agency (MQA)
REFEREES (Family members and relatives cannot serve as referees)
Name
Position
Organization
Phone Number Office:
(Compulsary)		 Mobile:
(Compulsary)
Email Address
Relationship


Name
Position
Organization
Phone Number Office:
(Compulsary)		 Mobile:
(Compulsary)
Email Address
Relationship

 

 

Malaysian Qualification Agency (MQA)
PART 4 : SELF DECLRATION


I hereby declare that all of the information/ documents provided to support this application are authentic, true and accurate. I fully undersrand the Terms and Conditions of the application and agree that my application will be rejected if I have falsified any information in any way.


Signature:
Name:
Date:



 

 

Malaysian Qualification Agency (MQA)
LIST OF EVIDENCE
Evidence that can be provided for application
Direct Evidence Indirect Evidences
Certificate
You can provide copies of your qualification
  • School certificates
  • Statement of resuts
  • Course completed at work
  • Digital badges/Malaysian Mirco-Credentials Statement (MMS)
    (The Digital Badge must contain the information embedded in the MMS)
    		•  Written Records
    You can provide copies of
  • Diaries
  • Records
  • Journals
  • Articles
    		•
    Work samples
    You can provide samples of your work
  • Drawings or photographs
  • Reports
  • Written materials
  • Projects
  • Objects
  • Work of arts
    		•  E-mail
    You can provide cpies of emails communictaions which verify
  • Customer feedback
  • Work activities
  • Written skills
    		•
    Records of workplace activities
    You can provide documents that verify your work activities
  • Notes
  • Emails
  • Completed worksheets
  • Workplace agreement
  • Contracts
    		•  Supporting letters
    You can provide letters to verify your claim from
  • Employers
  • Community group
  • People you have work with (paid and unpaid work)
    		•
    Documents
    You can provide evidence that shows what you have done in your life
  • Media articles
  • Meritoriuos Awards
    		•

     

     

    Malaysian Qualification Agency (MQA)
    Appendix 2
    List of skills on what I have learnt based on Malaysian Qualification Framework Learning Outcome
    1. Knowledge and understanding
    • Describe advances and comprehensive, theoretical and technical knowledge and demonstrate relevant skills in a specialized field
    2. Cognitive skills
    • Demonstrate intellectual independence in the application of knowledge within specific field(s) by applying critical, analytical and evaluation skills in teh field of study/work/practice
    Functional work skills:

    3. Practical skills
    • Apply range of essential methods and procedures to solving a broad range of complex problems. Review, make adjustments and supervise related practices and process concerning
    4. Interpersonal and communication skills
    • Convey ideas both in written or oral forms using appropriate and different forms of presentation, confifently, accurately and coherently in appropriate context in a well-structured manner to a diveristy of audiences
    5. Digital and numeracy skills
    • Use a broad range of information, media and technology applications to support study and/or work. use and combine numerical and graphical/visual data for study work.
    6. Leadership, autonomy and responsibility
    • Work autonomously, and show leadership and professionalism in managing responsibilities within broad organizational parameters. Undertake significant levels of work related responsibilities of others as well as self
    7. Personal and entrepreneurial skills
    • Demonstrate significant autonomy, independence, leadersjip and interpersonal skills ats work and class. Show substantial responsibility in planning, resource management, supervision and problem solving and managing work within own team and collaboratively with other teams especially in the context on complex application and unpredicatable situations
    8. Ethics and professionalism
    • Demonstrate adherence to legal, ethical and professional codes of practice. Demonstarte confidence to give advice and make decision(s) on complex issues based on critical reflection and ethical considerations