UNIVERSITI TEKNOLOGI PETRONAS

POSTGRADUATE STUDIES

APPLICATION FOR POSTGRADUATE STUDIES

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INSTRUCTIONS TO APPLICANTS:

1. Please fill in this form using

BLOCK LETTERS

.2. The following documents are required to be submitted together with this application form (please tick):`Four (4) recent passport-size photographsCertified true copies of Identification Card (IC) or passportCertified true copies of official academic transcripts and degree scrolls.Documentary evidence of financial supportRecommendations from two (2) referees A 2000-word research proposal (for research candidates only).

Please follow the “Guidelines to Writing Research Proposal”.

Please note, incomplete application forms may delay the processing of the forms. The University reserves the right to cancel, restructure or change the programmes according to the academic requirements.

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A. APPLICATION DETAILS

Degree Applied For MSc by Research PhD MSc by Coursework and DissertationProgramme of Study By Research By Coursework and DissertationChemical Engineering MSc Petroleum EngineeringCivil Engineering MSc Process IntegrationElectrical & Electronic Engineering MSc Petroleum GeoscienceMechanical Engineering MSc Electronic Systems DesignInformation Technology MSc Asset Management & MaintenanceMode of Study On Campus Off Campus

Academic Year Intake January July

For Research Programmes only

: Area of Specialization :Proposed Supervisor:

B. PERSONAL DETAILS

Full Name:(Underline your last name)Gender: Male Female NRIC/Passport No:Date of Birth: - - Place of Birth: Age: years Marital Status: Single Married DivorcedNationality: Ethnicity: Religion:Mailing Address:Postcode:Tel. No.: Fax: E-mail Address:Permanent Address:Postcode:

C. ACADEMIC QUALIFICATIONS

Please provide details of degree obtained from University/College/Other Tertiary Institutions

Period of studyQualification obtainedCGPA (orequivalent)Name of InstitutionFrom ToMedium of InstructionOther professional qualifications:Research experience:Publications (provide citations):

D. LANGUAGE PROFICIENCY

Proficiency in Malay language

(For local applicants only)

Grade Year PassedProficiency in Malay language in SPM/MCE

Proficiency in English language

(For all applicants)

Test Date Taken Grade/Point Obtained

E. WORKING EXPERIENCE

Please provide details of current and previous employment (start with the most recent)

Present Position :Business Address :Postcode:Tel No: Fax No: Email:

From To Position and Nature of Work Employer

F. FINANCIAL SUPPORT

Please indicate your source of financial support while studying at UTP.

I am a self-financed student/have financial support from my familyI am fully sponsored by my home government/employer/other organization (attach evidence)I am awarded a scholarship by __________________ (attach evidence)I am applying for the UTP Research Officer Postgraduate Assistantship Scheme (ROPAS)I am applying for the UTP Graduate Assistantship Scheme (GA)If my application for UTP ROPAS/GA Scheme is unsuccessful, I with to study as a full-fee payingstudent Yes No