Swiss School of Management
c/o University of Washington Rome Center
Piazza del Biscione 95
00186 Rome, Italy
info@ssmrome.com www.ssmrome.com
Phone: +39 327 74 88 870
Application Form Insert
Headshot Photo
(Please also
Last Name: THIVAGARAN First Name: SELVA RAJ attach your
digital photo as a
separate file.)
Today’s Date: 14/9/2022 Undergraduate or MBA: UNDERGRADUATE
Application for academic year: 201 / If MBA: Full-time/Part-time/Dual/Capital MBA:
Start Date: Specialization Request:
How did you find out about our program?
___ Facebook Ad ___ Google/Internet Search ___ www.studyabroad.com
___ www.goabroad.com ___ www.masterstudies.com ___ Study Abroad Fair (city) _________________
___ Referral* (Name & Email) DR SYED KADIR & drsyedkadir@gmail.com SSM Student
(Name)________________________ Other UNIES Education Group
Promo Code** UNIES Education Group
*The referral name written on this application is final and cannot be changed or added to once submitted. Referees will be paid 6 months after
the start date of the enrolled referred student. If the student is no longer enrolled, the referee will not be paid.
**Once an applicant submits their application with a specific promo code, they will no longer be eligible for future promotional offers/discounts.
Application process:
Step 1:MBA APPLICATION FORM SENT ELECTRONICALLY
A. Fill out the entire application form ELECTRONICALLY
B. Save WORD document
C. Attach saved WORD document file to an email and send to info@ssmrome.com.
NOTE: Please make sure the form is submitted in WORD. Do not fill in by hand and scan. Hand written
forms will NOT be accepted.
Step 2: APPLICATION FEE
Upon receiving an email from SSM stating we have received your application, pay the €100 application fee.
Step 3: SCANED COPIES
A. SCAN and EMAIL the following documents to info@ssmrome.com
(This may be done after the initial submission of your application)
All University Transcripts (If not in English they must be translated.)
Electronic passport photo (attached within this document and as a separate file. )
1 letter of recommendation (sent via email to info@ssmrome.com directly from the person providing the
recommendation. (If not in English it must be translated.)
English proficiency test results or certificate
The signature page of your application signed and dated
Note: Application will not be reviewed until all documents have been received electronically and the application fee
has been received
v12-2013 Page 1 of 7
Swiss School of Management
c/o University of Washington Rome Center
Piazza del Biscione 95
00186 Rome, Italy
info@ssmrome.com www.ssmrome.com
Phone: +39 327 74 88 870
Personal Information
Full Name: THIVAGARAN SELVA RAJ S/O
Last First Middle Initial
Place of Birth: PAHANG MALAYSIA
City Country
Date of Birth: 17 04 1989
Day Month Year
Nationality: MALAYSIAN Gender: V male female
Please list all countries of citizenship
Marital Status: V married single
Address for Correspondence
JALAN BATU
UNJUR 8 VISTA INDAH PUTRA C-G-7
Street Number Street Name PO Box
KLANG SELANGOR 41200 MALAYSIA
City State or Zip Code Country
Province
Telephone E-mail
No: ( +60 ) 0169684667 Address: tn619_007@hotmail.com
Country Phone number
Code
Permanent Address (if different than above)
Street Number Street Name PO Box
City State or Zip Code Country
Province
Telephone E-mail
No: ( ) Address:
Country Phone number
Code
Parents’ Info
Father’s Name SELVA RAJ Profession SITE SUPERVISOR (RETIREED)
(pls. specify)
Mother’s Name TAMIL SELVI Profession CUSTOMER SERVICE (RETIREED)
(pls. specify)
Emergency Contacts
Name of Contact # 1 ROGINI Phone Number 0146314134
Relation WIFE Email Address Roginiana@gmail.com
Name of Contact #2 NAREENDRAN Phone Number 0163684052
v12-2013 Page 2 of 7
Swiss School of Management
c/o University of Washington Rome Center
Piazza del Biscione 95
00186 Rome, Italy
info@ssmrome.com www.ssmrome.com
Phone: +39 327 74 88 870
Relation BROTHER Email Address ssnareenbfn6556@yahoo.co
m
Does your emergency contact speak English? Yes/No
If not, what language do they speak? ________________________________________________________
Please indicate the schools you have attended since the age of 14 (for undergraduate applicants)
18 (for MBA applicants) (Scan and email transcripts)
From To School/College/University Degree / Diploma Specialization (if any)
mth/year mth/year Name Address
2003 2004 SMK SRI ANDALAS SRI ANDALAS HIGH SCHOOL PMR
2005 2006 SMK RAJA MAHADI TAMAN KLANG JAYA HIGH SCHOOL SPM
2008 2009 KTAR KARAK, PAHANG CERTIFICATE ACCOUTING
2009 2012 KTAR KARAK, PAHANG DIPLOMA ACCOUNTING
If the answer to either of the following questions is “yes”, please give a detailed explanation. Use a separate sheet of
paper
a) Have you ever been dismissed from, subject to any disciplinary action at, any school or college? yes no
Any scholarships, awards, prizes obtained or examinations taken (pls. indicate)
Date Institution Description
Name Address
Sporting activities and hobbies
Since (year) Description of activity / hobby Awards received, if any
Any foreign country (ies) you have lived in for more than three months
From To Country (ies)
mth/year mth/year
v12-2013 Page 3 of 7
Swiss School of Management
c/o University of Washington Rome Center
Piazza del Biscione 95
00186 Rome, Italy
info@ssmrome.com www.ssmrome.com
Phone: +39 327 74 88 870
Languages
Indicate your level of oral and written language proficiency marking the appropriate figure according to the
instructions given below:
1 Complete Beginner with no 5 Ability to communicate well but 9 Through mastery of everyday and
previous experience with frequent errors specialist language
3 Some knowledge but insufficient 7 Good communication with 10 Mother tongue
for communication occasional errors
LANGUAGE ORAL (please check box) WRITTEN (please check box)
1 3 5 7 9 10 1 3 5 7 9 10
English V V
French
Italian
Spanish
Chinese V
Japanese
Other: TAMIL V
Other: MALAY V V
Please explain how you intend to finance your studies SELF PAY AND PLANING TO REQUEST FOR FINANCE FROM
CURRENT EMPLOYER
Please give the name and the address of person or body responsible for payment of your fees
Last Name/First Address (Street, P.O. ZIP City Country
Name /Company Street No.) Box Code
Do you need a visa? yes no
v12-2013 Page 4 of 7
Swiss School of Management
c/o University of Washington Rome Center
Piazza del Biscione 95
00186 Rome, Italy
info@ssmrome.com www.ssmrome.com
Phone: +39 327 74 88 870
Work Experience
Please complete this form with the most up to date information. If you do not currently work, please list your most recent job.
Last Name: THIVAGARAN First Name: SELVA RAJ Middle: S/O
Applicant for: V Undergraduate MBA Specialization: ACCOUNTING
Employing company: WESTMINSTER INTENNATIONAL COLLEGE Company Location: SUBANG JAYA
How long w/company: 5 YEARS Pls. mark: national V international company
Your actual function: ACCOUNTING
What is your employment level? (pls. mark)
employee lowest management level V medium management level upper management level
employment as an officer (public authorities)
own business without employees
owner / shareholder of a company with employees
What sector do you work in? (pls. mark)
aero industry logistics / transports
bank / insurance / finance / investment machinery industry / investments
car industry management consultant / trust / accounting
chemical / pharmaceutical industry medicine
construction industry / architecture public authorities / government
consumer goods - industry / trade social institution
V education sports / leisure
electrical engineering steel / heavy industry
hotel industry / gastronomy /catering trade tourism
information technology / telecom others:
Number of employees at your company Number of Employees you manage
(pls. mark) (pls. mark)
1–9 1’000 – 4’999 V none 100 – 299
V 10 – 99 5’000 – 9’999 1–9 more than 300
100 – 499 10’000 – 19’999 10 – 49
500 – 999 20’000 and more 50 – 99
Do you have responsibility for profit and loss? (pls. mark)
Responsibility for the budget within the scope of turnover resp. sales
V Yes, responsibility for a section of the company
Yes, responsibility for the entire national international company
no responsibility
v12-2013 Page 5 of 7
Swiss School of Management
c/o University of Washington Rome Center
Piazza del Biscione 95
00186 Rome, Italy
info@ssmrome.com www.ssmrome.com
Phone: +39 327 74 88 870
Work Experience (continued)
What are the milestones (marks) of your professional career?
From To Function Position Company Country
(year) (year)
2012 2012 AUDIT AUDIT ASSOCIATES 2 YHL & ASSOCIATES MALAYSIA
2012 2013 AUDIT AUDIT ASSOCIATES 1 YHL & ASSOCIATES MALAYSIA
2013 2013 AUDIT SEMI SENIOR 2 YHL & ASSOCIATES MALAYSIA
2013 2014 AUDIT SEMI SENIOR 1 YHL & ASSOCIATES MALAYSIA
2014 2017 ACCOUNTING ASSISTANT L SINNISH AND ASSOCIATES MALAYSIA
ACCOUNTNAT
2017 PRESENT ACCOUNTING ASSISTANT WESTMINSTER MALAYSIA
ACCOUNTNAT INTERNATIONAL COLLEGE
What are your goals for after graduation? (pls. mark/indicate)
to be a member of the board of directors
to be a member of management
to change from technical to general management
V to improve salary
V to improve qualification of manner/method of action
V to establish my own business
other intention:
What are your expectations related to the studies you wish to complete at the Swiss School of Management? (pls.
mark/indicate)
General knowledge in management
Update to the latest know-how and perceptions in management from Europe and the USA
V Improved strategic knowledge
Important professional contacts/relations with other participants/students
Possibilities to work scientifically
Contacts/relations to highly qualified professors from Europe and the USA
V Practice related study cases
V Development of personality and attitudes as a manager or entrepreneur
V Development of human qualities
Experience and knowledge in new learning and teaching technologies (NLP, LPS, etc.)
other expectations:
Declaration:
I am applying for admission to the above Academic program at the Swiss School of Management. I attest that all
information given in this application is true to the best of my knowledge. I understand that the decision to offer me
a place in the program rests with the Swiss School of Management whose decision is irrevocable. If I am offered and
accept a place in the program, I undertake to abide by the rules and regulations of the Swiss School of Management
and to ensure payment of all fees. I confirm that to the best of my knowledge the information given in this
application form and in the attachments is complete and accurate. I do also agree, that once I do obtain my entry
visa, my tuition fee is due to SSM and no payback will be made if I withdraw from the course, program or school.
(Please sign and date this form, scan it and return with your application form)
Signature :
Name in capital letters :
Place / Date:
For SSM Admissions office use only:
v12-2013 Page 6 of 7
Swiss School of Management
c/o University of Washington Rome Center
Piazza del Biscione 95
00186 Rome, Italy
info@ssmrome.com www.ssmrome.com
Phone: +39 327 74 88 870
Personal Statement
Below, please write an essay about yourself and include the following information: (400-500 words)
a) Information about your background, helping us to assess your skills and suitability for the program
b) Your reasons for choosing the course at Swiss School of Management
c) The challenges facing you in your studies, work or personal career development
d) Your professional dream
e) Description of what you are looking for in this academic program
MY NAME IS THIVAGARAN SELVA RAJ AND I AM 33 YEARS OLD. I GROW UP IN KLANG, SELANGOR AND FINISH MY HIGH
SCHOOL IN SMK RAJA MAHADI, KLANG IN 2006. I STARTED WORKING AFTER MY HIGH SCHOOL DUE TO FINANCIAL
PROBLEM AND JOIN COLLEGE TUNGKU ABDUL RAHMAN, KARAK PERSUING MY CERTIFICATE IN ACCOUNTING AND
MOVED ON TO DIPLOMA AND GRADUATE IN YEAR 2012.
MY REASON FOR CHOSING THE COUSE AT SSM IS MAINLY DUE TO RECOMMENDATION FROM ONE OF OUR SENIOR
LECTURER WHO I DID AS ADVICE FOR MY CAREER PEOGRESSION AND THE FEES ALSO LOOKING AFFORTABLE.
SINCE I AM WORKING ADULT MOST OF THE TIME IT’S THE ALLOCATION OF THE RESOURCES AND TIME WILL BE A
CHALLENGING PART IN STUDIES AND WOKING WISE WILL THE DEVELOPMENT IN
v12-2013 Page 7 of 7
