Limkokwing International Lifestyle Design Academy

Name:
Gender:	Male Female
Date of Birth:	- -
Address:
City/Town:
State:
Postcode:
Country:
Telephone no. (Home):
Telephone no. (Office):
Handphone no:
Fax no:
Email:
Qualification (Highest):	SPM STPM O Level A Level
How did you hear about us?
When do you intend to enrol with us ?
Comments: