Professional Documents
Culture Documents
1. FAKULTI/INSTITUT/PUSAT :
(FACULTY/INSTITUTE/CENTRE)
2. JABATAN :
(DEPARTMENT)
3. PENGKHUSUSAN :
(SPECIALTY)
Diisi oleh pemohon (To be filled in by applicant)
Kepada (To) :
Nama Pemohon & Alamat
Terima kasih kerana telah memohon bagi mengikuti Program Pengajian Siswazah di Universiti Kebangsaan Malaysia. Sekian dimaklumkan.
Thank you for applying to the Graduate Studies Programme in Universiti Kebangsaan Malaysia.
b.p : Pengarah/Director
Pusat Pengurusan Siswazah (PPS)
Centre for Graduate Management
Universiti Kebangsaan Malaysia (UKM)
Sila hubungi No. Telefon mengikut Fakulti yang dinyatakan bagi mengetahui status permohonan anda (03-8921 … sambungan)
Contact the following number to know the status of your application (03-8921… extension)
(Sambungan/Extension )
3764 : Fakulti Sains Sosial & Kemanusiaan/Faculty of Social Science and Humanities
3764 : Fakulti Perubatan/Faculty of Medicine DAN/AND Fakulti Pergigian/Faculty of Dentistry
4515 : Fakulti Teknologi & Sains Maklumat/Faculty of Information Science and Technology
4515 : Fakulti Kejuruteraan dan Alam Bina/Faculty of Engineering and Built Environment
4515 : Fakulti Sains dan Teknologi/Faculty of Science and Technology
3896 : Fakulti Sains Kesihatan Bersekutu/Faculty of Allied Health Sciences DAN/AND Fakulti Farmasi/Faculty of Pharmacy
5338 : Fakulti Ekonomi & Perniagaan/Faculty of Economics and Business DAN/AND Fakulti Undang-Undang/Faculty of Law
3795 : Fakulti Pengajian Islam/Faculty of Islamic Studies
5162 : Fakulti Pendidikan/Faculty of Education
5338 : Institut-Institut UKM/UKM Institutes
4516/4445 : Imigresen/Immigration
Lekatkan gambar
berukuran
pasport di sini
Please attach
passport-size
Mengilham Harapan, Mencipta Masa Depan photograph here
Inspiring Futures, Nurturing Possibilities
BAHAGIAN A (PART A)
1. JENIS PROGRAM : Doktor Falsafah (PhD)
(TYPE OF PROGRAMME)
Sarjana (Masters)
4. NAMA :
(NAME)
5. TARIKH LAHIR :
(BIRTH DATE)
Hari (Date) Bulan (Month) Tahun (Year)
7. JANTINA :
Lelaki (Male) Perempuan (Female)
(SEX)
8 AGAMA :
(RELIGION)
Lain-lain (Others)
[Sila Nyatakan (Please State) ]
10. KEWARGANEGARAAN :
(NATIONALITY)
11. KAUM :
(ETHNIC)
12. TARAF PERKAHWINAN : Bujang Berkahwin
(MARITAL STATUS) (Single) (Married)
3. FAKULTI/INSTITUT/PUSAT :
(FACULTY/INSTITUTE/CENTRE)
4. JABATAN :
(DEPARTMENT)
5. PROGRAM PENGAJIAN :
(PROGRAMME)
6. PENGKHUSUSAN :
(SPECIALTY)
BAHAGIAN C (PART C)
1. ALAMAT SURAT-MENYURAT :
(MAILING ADDRESS)
2. ALAMAT TETAP :
(PERMANENT ADDRESS)
3. NO. TELEFON :
(TELEPHONE)
4. TELEFON BIMBIT :
(MOBILE)
5. MEL-E :
(E-MAIL)
BAHAGIAN D (PART D)
1. JAWATAN SEKARANG :
(PRESENT POSITION/OCCUPATION)
2. NAMA & ALAMAT MAJIKAN SEKARANG :
(NAME & ADDRESS OF PRESENT EMPLOYER)
4. BANTUAN KEWANGAN : Saya dibiayai penuh oleh majikan/kerajaan negara saya (sertakan dokumen berkenaan)
(FINANCIAL SUPPORT) (I am fully sponsored by my employer/home government (please attach relevant document)
Saya seorang pelajar persendirian dibiayai oleh saya sendiri/keluarga saya
(I am self sponsored)
[Sila tandakan √ dalam petak berkenaan (Please tick √ in the appropriate box)]
Nama dan alamat penaja atau organisasi :
yang akan membayar yuran anda
(Name and address of person or organization
responsible for your fees)
(Sila sertakan DUA (2) salinan surat tajaan atau biasiswa. / Please attach TWO (2) copies of the sponsorhip or scholarship offer letter.)
BAHAGIAN E (PART E)
1. NAMA SUAMI/ISTERI :
(NAME OF SPOUSE)
2. NEGERI & NEGARA KELAHIRAN SUAMI/ISTERI :
(SPOUSE'S STATE & COUNTRY OF BIRTH)
3. TARIKH LAHIR SUAMI/ISTERI :
(SPOUSE'S DATE OF BIRTH)
Hari (Date) Bulan (Month) Tahun (Year)
4. NO. PASPORT SUAMI/ISTERI :
(SPOUSE'S PASSPORT NO.)
5. MAKLUMAT ANAK
(INFORMATION ON CHILDREN)
Nama Anak No. Pasport Tarikh Lahir
Name of Children Passport No. Date of Birth
BAHAGIAN F (PART F)
1. KELAYAKAN PROFESIONAL
(PROFESSIONAL QUALIFICATION)
Kelulusan Tahun Dianugerah Dianugerahkan oleh
(Qualification) (Year Awarded) (Awarded by)
[Sila lampirkan salinan sah sijil/surat berkenaan (Please attach certified copies of documents) ]
2. KELAYAKAN AKADEMIK
(ACADEMIC QUALIFICATION)
Ijazah/Diploma Diperolehi Nama Institusi PNGK/Kelas Tahun Pengajian
(Degree/Diploma) (Institution) (CGPA/Class) (Years Attended)
4. PENERBITAN PROFESIONAL
(PROFESSIONAL PUBLICATION)
Tajuk Buku/Jurnal Tahun Diterbit Nama dan Tempat Penerbitan
(Title of Book/Journal) (Year of Publication) (Name and Location of the Publication)
[Sila lampirkan salinan sah muka hadapan buku/jurnal berkenaan (Please attach certified copies of the front page the book(s) / journal(s) ]
[Please enclose TWO (2) copies of any other Language Qualification results]
BAHAGIAN G (PART G)
1. TAJUK PENYELIDIKAN IJAZAH PERTAMA :
[SARJANA MUDA]
(TOPIC OF UNDERGRADUATE BACHELOR DEGREE'S
RESEARCH)
[Sila sertakan abstrak tesis/penyelidikan berkenaan. (Please attach the abstract of the thesis/research) ]
BAHAGIAN H (PART H)
1. NAMAKAN BIDANG PENGAJIAN ATAU :
PENYELIDIKAN YANG ANDA MINATI/PILIH
(STATE THE FIELD OF STUDY OR RESEARCH IN WHICH
YOU ARE INTERESTED/HAVE CHOSEN)
BAHAGIAN I (PART I)
1. PERAKUAN PEMOHON
(DECLARATION BY APPLICANT)
Saya akui bahawa segala maklumat dan dokumen yang saya berikan adalah benar dan lengkap. Saya akui bahawa Universiti Kebangsaan Malaysia berhak menolak
permohonan saya sekiranya maklumat serta dokumen didapati tidak benar dan tidak lengkap.
(I declare that all information and documents provided are true and complete. I acknowledge that Universiti Kebangsaan Malaysia may reject my application if
the information and documents provided are found to be false or incomplete)
BORANG PERMOHONAN INI BERSERTA DENGAN DOKUMEN-DOKUMEN SOKONGAN HENDAKLAH DIHANTAR TERUS KEPADA :
(THIS FORM, TOGETHER WITH SUPPORTING DOCUMENTS SHOULD BE SENT TO):
PENGARAH (DIRECTOR)
PUSAT PENGURUSAN SISWAZAH
(CENTRE FOR GRADUATE MANAGEMENT)
UNIVERSITI KEBANGSAAN MALAYSIA
43600 UKM BANGI, SELANGOR
MALAYSIA
Mengilham Harapan, Mencipta Masa Depan
Inspiring Futures, Nurturing Possibilities
(1)
BORANG PENJAMIN KEWANGAN
(1)
(FINANCIAL GUARANTOR FORM)
1. NAMA PEMOHON :
(APPLICANT'S NAME)
2. NO. PASPORT :
(PASSPORT NO.)
1. NAMA PENJAMIN :
(GUARANTOR'S NAME)
6. TELEFON BIMBIT :
(MOBILE)
7. PEKERJAAN :
(OCCUPATION)
8. PENDAPATAN SEBULAN :
(INCOME PER MONTH)
Saya mengaku akan menjelaskan segala bayaran pengajian pemohon di UKM sekiranya pemohon tidak mampu/gagal menjelaskannya
(I hereby declare that I will settle all the outstanding payments due to UKM for the applicant for his/her study at UKM in the event that he/she is unable to do so)
(2)
BORANG PENJAMIN KEWANGAN
(2)
(FINANCIAL GUARANTOR FORM)
1. NAMA PEMOHON :
(APPLICANT'S NAME)
2. NO. PASPORT :
(PASSPORT NO.)
1. NAMA PENJAMIN :
(GUARANTOR'S NAME)
6. TELEFON BIMBIT :
(MOBILE)
7. PEKERJAAN :
(OCCUPATION)
8. PENDAPATAN SEBULAN :
(INCOME PER MONTH)
Saya mengaku akan menjelaskan segala bayaran pengajian pemohon di UKM sekiranya pemohon tidak mampu/gagal menjelaskannya
(I hereby declare that I will settle all the outstanding payments due to UKM for the applicant for his/her study at UKM in the event that he/she is unable to do so)
BAHAGIAN A (PART A)
Diisi oleh pemohon (To be filled in by applicant)
1. NAMA :
(NAME)
2. NO. KAD PENGENALAN/NO. PASPORT :
(IC NO./PASSPORT NO.)
3. JENIS PROGRAM : Doktor Falsafah (PhD) Diploma Pascasiswazah (Postgraduate Diploma)
(TYPE OF PROGRAMME) Sarjana (Masters) Diploma Siswazah (Graduate Diploma)
4. PROGRAM PENGAJIAN :
(STUDIES PROGRAMME)
5. FAKULTI/INSTITUT/PUSAT :
(FACULTY/INSTITUTE/CENTRE)
BAHAGIAN B (PART B)
Diisi oleh Penyokong (To be filled in by Referee)
1. NAMA PENYOKONG :
(REFEREE'S NAME)
2. JAWATAN :
(OFFICIAL POSITION)
3. NAMA DAN ALAMAT MAJIKAN :
(EMPLOYER'S NAME AND ADDRESS)
Tarikh (Date) Tandatangan dan Cop Rasmi (Signature and Official Stamp)
Mengilham Harapan, Mencipta Masa Depan
Inspiring Futures, Nurturing Possibilities
(2)
BORANG PENYOKONG
(2)
(REFEREE FORM)
PERMOHONAN BAGI MENGIKUTI PROGRAM PENGAJIAN SISWAZAH
APPLICATION FOR GRADUATE STUDIES PROGRAMME
Penyokong-penyokong hendaklah bukan terdiri daripada kawan atau saudara mara sendiri dan salah seorangnya hendaklah yang boleh memberikan laporan pencapaian
akademik anda.
The referees must not be personal acquaintances or relatives and at least one of the referees must be able to provide information/background of the applicant's academic
standing.
Perhatian : Borang yang tidak lengkap tidak akan diproses / (Note : Incomplete forms will not be processed)
BAHAGIAN A (PART A)
Diisi oleh pemohon (To be filled in by applicant)
1. NAMA :
(NAME)
2. NO. KAD PENGENALAN/NO. PASPORT :
(IC NO./PASSPORT NO.)
3. JENIS PROGRAM : Doktor Falsafah (PhD) Diploma Pascasiswazah (Postgraduate Diploma)
(TYPE OF PROGRAMME) Sarjana (Masters) Diploma Siswazah (Graduate Diploma)
4. PROGRAM PENGAJIAN :
(STUDIES PROGRAMME)
5. FAKULTI/INSTITUT/PUSAT :
(FACULTY/INSTITUTE/CENTRE)
BAHAGIAN B (PART B)
Diisi oleh Penyokong (To be filled in by Referee)
1. NAMA PENYOKONG :
(REFEREE'S NAME)
2. JAWATAN :
(OFFICIAL POSITION)
3. NAMA DAN ALAMAT MAJIKAN :
(EMPLOYER'S NAME AND ADDRESS)
Tarikh (Date) Tandatangan dan Cop Rasmi (Signature and Official Stamp)