Appendix A Level Ref. number (Office use only) : Certificate/Diploma/Bachelors : APEL REGISTRATION FORM (CERTIFICATE / DIPLOMA / BACHELOR) ACCREDITATION OF PRIOR EXPERIENTIAL LEARNING (APEL) FULL NAME: (AS IN IC) CORRESPONDENCE ADDRESS: IC NUMBER: DATE OF BIRTH: GENDER: CONTACT NUMBERS: LEVEL OF INTENDED STUDY: Male / Female HOME: OFFICE: FAX: MOBILE: E-MAIL: CERTIFICATE/DIPLOMA/BACHELORS DEGREE HIGHEST QUALIFICATION:
APEL PORTFOLIO Recent photo PART 1 : PERSONAL DETAILS FULL NAME IC NUMBER REFERENCE NUMBER (for OUM use only)
PART 2: DETAILS LEARNING ACQUIRED (start with the most recent) a) FORMAL LEARNING (CERTIFICATED) EDUCATION YEAR AWARDED TITLE OF CERTIFICATION LEVEL OF THE AWARD (CERTIFICATE/DIPLOMA/ DEGREE) AWARDING BODY COMPETENCIES (please tick ) GENERIC NUMERICAL LANGUAGE ICT 1.Example: 1999 2. SIJIL PELAJARAN MALAYSIA (SPM) CERTIFICATE LEMBAGA PEPERIKSAAN MALAYSIA 3. 4. 5.
b) EXPERIENTIAL LEARNING No. NAME OF EMPLOYER /SELF EMPLOYED EMPLOYMENT HISTORY A description of the associate of evidence and knowledge, competency, performance or experience: CONTACT ADDRESS TIME SERVED (MONTH/YEAR) POSITION HELD JOB ROLES / PERFORMED (Please tick ) 1: OPERATIONAL 2: MANAGERIAL 1. ABC Sdn. Bhd. Wisma Batu 3, Shah Alam FROM TO 1 2 OTHER (Please Specify) July 2012 Current Assistant Manager (Briefly describe your job scope in this company) 2. Syarikat Gading Bersama Menara XYZ, Kuala Lumpur Feb 1999 Jun 2012 Senior Executive (Briefly describe your job scope in this company) 3. 4. 5. 6.
No. NAME/TITLE OF TRAINING OR COURSE TRAINING ACTIVITIES LOCATION DATE LENGTH (Hours/Days/Month) WHAT I HAVE LEARNT? (Please tick where relevant) (Refer Appendix II for list of skills on what I have learnt) 1. 2. 3. 4. 5. 6. 7. 8. 1. 5S Workshop Hotel Eastin, Petaling Jaya 2. Effective Communication How to Handle Customer Complaints 3. UPM, Serdang 2 nd May 2013 1 3 Feb 2009 1 Day 3 Days 4. 5. 6. 7.
c) OTHER LEARNING SKILLS / ACTIVITIES OTHER ACTIVITIES This may include your hobbies/sports/recreation/ social/community service /training given / consultancy services or other activities which might be relevant to the competencies. YEAR WHAT I HAVE LEARNT? (Please tick where relevant) (Refer Appendix II for list of skills on what I have learnt) 1. 2. 3. 4. 5. 6. 7. 8. 1. Marshall Of Local Cycling Club Present 2. Coach for Under-18 Taman Maju Boys Soccer Team 2014 - Present 3. 4. d) LANGUAGE SKILLS LANGUAGE LEVEL OF COMPETENCE (Tick where relevant) 1: POOR; 2: AVERAGE; 3: GOOD; 4: EXCELLENT LISTENING READING SPEAKING WRITING 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1. Bahasa Malaysia 2.English Language
3. e) SELF ASSESSMENT/REFLECTION (Compulsory) Describe how your prior learning experiences prepare you to undertake the intended level of study (Not more than 250 words): 1. Why do you want to study? (Min 100 words) 2. Describe your experience in relation to the programme of study. (Min 150 words) Example: I intend to pursue a Business degree in General Management. I have 10 years of work experience. From an executive level, I have been promoted to an Assistant Manager. I need to improve my qualifications for a better career path. I believe that I have gathered enough hands-on experience in the supervisory field that will help me to successfully complete the programme. However I need to learn the theories relevant to management and for that reason I m really interested in enrolling in the programme.
PART 3: EVIDENCE OF LEARNING a) LIST OF ITEMS PROVIDED (Please refer Appendix I for list of evidence). NO. 1. Sijil Pelajaran Malaysia (SPM) TITLE OF ITEM 2 Job Appointment Letters 3. To include all evidence that support the information provided. 4. 5. 6. 7. 8.
b) REFEREES (relevant to work situation) NAME POSITION ORGANISATION PHONE NUMBER EMAIL ADDRESS RELATIONSHIP OFFICE: (Compulsory) MOBILE: NAME POSITION ORGANISATION PHONE NUMBER EMAIL ADDRESS RELATIONSHIP OFFICE: (Compulsory) MOBILE:
PART 4: SELF DECLARATION I hereby declare that all of the information/documents provided to support this application are authentic, true and accurate. I fully understand 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: This application is subject to Terms and Conditions stated below a. Documents that are not in English or Bahasa Malaysia must be accompanied by a certified full translation. b. The Management of OUM is authorised by the applicant, to make references to and use the information or data in this application as may be deemed necessary. c. The certification applied for is designed to meet requirements set by the Malaysian Qualifications Agency (MQA). Admission to the Academic Programme applied for, using this APEL Certificate is subject to the Academic Regulations approved by OUM. CHECK LIST Photocopy IC Application Fee (Banker s Cheque/Draft No ) 1 recent passport size photographs Certified Certificates/Documents 3 copies of application Yes No For Office Use Acknowledgment Name: Date:
Appendix I LIST OF EVIDENCE Evidence that can be provided for application Direct Evidence Indirect Evidence Certificates You can provide copies of your qualification School certificates Statement of results Courses completed at work Work samples You can provide samples of your work Drawings or photographs Reports Written materials Projects Objects Work of arts Records of workplace activities You can provide documents that verify your work activities Notes Emails Completed worksheets Workplace agreeement Contracts Written Records You can provide copies of Diaries Records Journals Articles E-mail You can provide copies of email communications which verify Customer feedback Work activities Written skills 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
Appendix II List of skills on what I have learned based on 8 Learning Outcomes Domain. 1. Knowledge 2. Practical Skills 3. Social skills and responsibilities 4. Values, attitudes and professionalism 5. Communication, leadership and team skills 6. Problem Solving and scientific skills 7. Information management and lifelong learning skills 8. Managerial and entrepreneurial skills