Self Declaration System

Please select *

Sila pilih

Full Name as per NRIC or Passport *

Nama mengikut Kad Pengenalan atau Pasport

Mobile Number (Sample: 60123456789) *

No. Telefon Bimbit (Contoh: 60123456789)

Have you been in close contact with a confirmed case of COVID-19 in the past 7 days? *

Pernahkah anda mempunyai kontak rapat dengan pesakit COVID-19 yang disahkan dalam tempoh 7 hari yang lalu?

No / Tidak

Yes / Ya

Are you exhibiting any of the symptoms as listed below? *

Adakah anda mengalami gejala seperti yang berikut?

• Cough / Batuk

• Sore throat / Sakit tekak

• Flu / Selsema

• Fever / Demam

• Shortness of breath / Sesak nafas

• Lose sense of smell or taste / Hilang deria rasa dan bau

No / Tidak

Yes / Ya

Please confirm all the information is correct, and tick all the declaration checkboxes below.

Full Name
Phone No
Role
Business Unit
Department
Student ID
Name of person or Department of the person you are meeting
Purpose of your visit
Have you been in close contact with a confirmed case of COVID-19 in the last 7 days?
Are you exhibiting any of the symptoms as listed below? • Cough / Batuk • Sore throat / Sakit tekak • Flu / Selsema • Fever / Demam • Shortness of breath / Sesak nafas • Lose sense of smell or taste / Hilang deria rasa dan bau

If you have answered 'Yes' to any of the questions above, you will be denied entry to the campus.

Sekiranya anda telah menjawab 'Ya' untuk salah satu daripada soalan di atas, anda akan dilarang untuk masuk ke kampus.

I declare that the information provided in this form is complete, true and accurate. I acknowledge that any false declaration may be subjected to disciplinary and/or legal action as provided for under the law by the authorities. *

Saya mengesahkan bahawa maklumat yang diberikan dalam borang ini adalah lengkap, benar dan tepat. Saya mengakui bahawa sebarang pernyataan palsu boleh dikenakan tindakan tatatertib dan / atau undang-undang sebagaimana yang diperuntukkan di bawah undang-undang oleh pihak berkuasa. *

I agree to the collection, use and disclosure of my personal data by Sunway Education Group for the purpose of precautionary measure against COVID-19 and contact tracing. *

Saya bersetuju dengan pengumpulan, penggunaan dan pendedahan data peribadi saya oleh Sunway Education Group untuk tujuan langkah berjaga-jaga terhadap COVID-19. *

A copy of your declaration will be submitted to MySejahtera to comply with the Malaysian Government regulations *

Salinan borang akuan anda akan dihantar ke MySejahtera untuk mematuhi peraturan Kerajaan Malaysia. *

99.