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aapplican form_word

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aapplican form_word

    Reference No. UTM(PS)-02/93 (Pind. 1/2005/1/2007)

     SCHOOL OF GRADUATE STUDIES

    UNIVERSITI TEKNOLOGI MALAYSIA 81310 UTM SKUDAI, JOHOR AFFIX RECENT MALAYSIA PASSPORT TELEPHONE: (+6) 07-5537790/37814/37891 FAX: (+6) 07-5537800 SIZED PHOTOGRAPH APPLICATION FOR ADMISSION TO POSTGRADUATE STUDY SESSION* 2010/2011 SEMESTER* I (JULY) / II (DECEMBER)

    NOTES: 1. Please provide all information requested and ensure that testimonials, transcripts and other supporting documents are submitted together with this form. 2. The application form and all documents must be submitted in TWO (2) sets. 3. Please read the Important Notes to Applicants at the end of this form.

    A. PERSONAL DATA

    Full Name As In Passport/Identity Card (IN BLOCK LETTERS)

    YAP ENG CHUAN

    Correspondence Address: 47, JALAN SETIA 11/8, TAMAN SETIA INDAH, 81100, JOHOR BAHRU, JOHOR. Permanent Address (If different from above):

    Telephone: 07-3526637 Mobile Phone: 012-7702337 Email :engchuan.yap@gmail.com

    Country of Birth:MALAYSIA Date of Birth: (Day/Month/Year) IC (Malaysian) / Passport No (International).:

    26 / 09 / 1983 830926-08-6331

    Nationality:MALAYSIAN Sex M F Religion: BUDDHA /

    Do you suffer from any form of disease/physical or other disability: If YES, please specify: - NIL -

     B. STUDY INFORMATION

     / Level of Study: Master Ph.D Eng. Doc

    Master of Management (Technology) Name of Faculty: Management & Human Resource

    Programme: Development

    Pelase specify: Mainstream (Perdana) Special (Khas) Off Campus (Pesisir) / Type of Study:

    / Mode of Study: Taught Course Taught Course & Research Research

    Pelase specify: / Campus : Skudai Kuala Lumpur Others

    ……………………………………..

    Form of Registration: Full Time Part Time /

    Title of Research (by research programme):

    Proposed Supervisor :

    1 * Please refer to the Graduate Admission Guidebook. Mark ? in the relevant boxes.

C. ACADEMIC ACHIEVEMENT

    (Please attach certified copy of your certificate/diplomas/degrees and transcripts)

    HIGHER DEGREE QUALIFICATION

    DATE OF CLASS OF YEAR OF STUDY NAME OF INSTITUTION OF HIGHER NAME OF AWARD/ HONOURS / LEARNING / UNIVERSITY DEGREE/DIPLOMA FROM TO COMPLETION CGPA

    UNIVERSITI TEKNOLOGI MALAYSIA MAY MAY BACHELOR OF 2 SEPTEMBER SECOND

     2001 2006 ELECTRICAL 2006 UPPER

     (TELECOMMUNICCGPA 3.49

     ATION)

     ENGINEERING

ENGLISH LANGUAGE PROFICIENCY**

    English: Written Excellent / Oral: Excellent /

     Good Good

     Fair Fair

    **Please provide evidence of any English Language qualifications :

    (e.g. score points of TOEFL/IELTS/MUET)

    D. WORK EXPERIENCE (INCLUDING PRESENT JOB)

    PERIOD OF EMPLOYMENT NAME & ADDRESS OF POSITION RESPONSIBILITY EMPLOYER FROM TO

    PROCESS ENGINEER MAY 2006 AUG 2009 VENTURE TECHNOCOM SDN MANUFACTURING

     BHD OPERATION

     CONTROL AND

     DEVELOPMENT

    TELECOMMUNICATION AUG 2009 PRESENT MAXVENTURE ENGINEERING TECHNICAL SITE

    ENGINEER SERVICES SURVEY

E. FINANCIAL SUPPORT

    Please indicate means of Financial Support :

    a) Self - Sponsored /

    *b) Employer - Sponsored ………………………………………..………………………………………..

    *c) Others (Please state) ………………………………………..……………………………………….. * Please provide Letter of Sponsorship.

School of Graduate Studies 2 Universiti Teknologi Malaysia

F. REFEREES

    Give names and addresses of two senior persons acquainted with your academic work that you have asked to write on your behalf

    indicating your academic fitness and general suitability to undertake the course for which you are applying.

     (i) (ii)

    NAME:

    OFFICE ADDRESS:

OCCUPATION/POSITION:

TELEPHONE/FAX NO.:

    E-MAIL:

G. DECLARATION

    I certify that all information given in this application form is correct. I agree to the condition that the University has the

    right to reject this application, to withdraw the offer of admission or to terminate my study if any information given is

    found to be incorrect. I also undertake to observe and ensure payment of all fees and other liabilities.

    .................23 September 2010......................... ....................................................

    Date Signature

    IMPORTANT NOTES TO APPLICANTS 1. Please complete this Application Form, enclose all the required documents in TWO SETS and send them to: DEAN

    SCHOOL OF GRADUATE STUDIES

    UNIVERSITI TEKNOLOGI MALAYSIA

    81310 UTM SKUDAI

    JOHOR

    MALAYSIA 2. Please attach a copy of the offer letter for sponsored student. 3. If the application is intended for a Master’s or PhD degree by research, you are required to prepare a brief research

    proposal (about 3-5 pages) and submit it together with the application form. The proposal should contain the following

    items: Title

    Chapter 1 Introduction

    o Background of the problem

    o Statement of the problem & Objectives of the study

    o Significance & Scope of the study

    Chapter 2 Literature Review

    o Review relevant research to provide rationale for your work

    o Present unanswered questions, untried method

    o Findings of others you are challenging or extending

    Chapter 3 Research Methodology

    o Research Design & Procedure

    o Operational Framework

    o Subjects or data sources

    o Research Plan & Schedule

    Chapter 4 Expected Findings and Summary

    List of References 4. Incomplete application form or if the application is not attached by certified true copies of the candidate’s

    Degree/Diplomas/Certificates and transcripts shall be considered null and void.

5. If you are on employment, please obtain a release letter from the current job or a permission to register as postgraduate

    student at UTM. 6. Please attach a processing fee of RM20.00 for Malaysian applicants and USD30.00 for international applicants in either a

    Bank Draft or Cashier’s Order mode, payable to “BENDAHARI, UNIVERSITI TEKNOLOGI MALAYSIA”. 7. Decision by the Selection Committee is final.

    School of Graduate Studies 3 Universiti Teknologi Malaysia

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