STUDENT EXCHANGE PROGRAM APPLICATION FORM 2014

General Require en!"

Registered as Law Faculty students either Regular or International Program. Must be an active students shown by reference letter from Faculty. Copy of student card and identity card Have completed their first year and not ta en free course yet. Please note that those who are in the first or second semester are not eligible to apply. Must have a minimum !P" of #.$. Must have a valid minimum %&'FL score of (($ or I'L%) *.$. +%&'FL prediction or %&'FL,li e score is accepted-. Please submit a certified copy of %&'FL or I'L%). .illing to cover the whole cost during e/change program. Involve actively in student activities or community would be beneficial.

General A##li$a!i%n In"!ru$!i%n"

)ubmit completed original application with signature on the last page. Please answer "LL 0uestions on the application in 'nglish. 1o 2&% leave a space blan . If a 0uestion does not apply to you3 write 2&2' +if not applicableHand written application is not acceptable. "pplication must be typed

"pplicants must attach all supporting documents re0uired. Completed application forms missing one or more supporting documents re0uired will not be included in the selection process. For the list of supporting documents3 please refer to the 1&C4M'2% CH'C5LI)% section. )ubmit application by the deadline +February 63 7$89-. DOCUMENT CHEC&LIST

PLEASE ARRANGE THESE DOCUMENTS IN THIS ORDER' RE(UIRED DOCUMENTS and signed a##li$a!i%n )%r . for the last *
(. 8

8. Completed 7. 8

+one- le+ali.e/ $%#0 %) 0%ur uni1er"i!0 !ran"$ri#! re$%r/" from the 8st semester to the last semester prior to the semester you are currently in. copy of student card

+one- color #*%!%+ra#* , - 4 $ month : affi/ it in the provided bo/.

*. 8 +one<. 8

#. 8 +one9. "n

certified copy of %&'FL or I'L%).

+one- copy of 1ali/ I/en!i)i$a!i%n Car/ 2&TP3. 1o not cut into 5%P si=e. +does not have to be translated-

send the application pac age to %))i$ial le!!er %) enr%ll en! fromPlease university3 RECOMMENDED DOCUMENTS r/ stating that you are still an active student and have IP not O))i$e , Fl%%r 4l' Ta an Si"5a N%' 167 8%+0a9ar!a graduated yet;not completed any graduation process3 8.Copies of certificates or awards received +including sidang skripsi dan tutup teori"pplication 1eadline>Fe:ruar0 7; 2014 F%r a//i!i%nal in)%r a!i%n; $%n!a$!< IP &ffice > $6<<#?#?69($ +$7<9- #<?8<6 e/t 77<;77?. .e do not accept email applications. Hard copies must be sent or delivered to IP &ffice Faculty of Law.

STUDENT EXCHANGE PROGRAM APPLICATION FORM 2014

Per"%nal In)%r a!i%n
Na e %) a##li$an! <
Mr. Last 2ame First 2ame Ms. > >
Affix your recent self color photograph (3X4) in this box

Middle 2ame+s- >

H% e A//re"">

H% e P*%ne< M%:ile P*%ne< E= ail<

Pla$e %) :ir!* < Ci!0 %) :ir!* < C%un!r0 < Gen/er< Male Female

Mari!al "!a!u"<

Da!e %) :ir!* < M%n!* %) :ir!* < 8ear %) :ir!* < D% 0%u *a1e a #a""#%r!>

)ingle Married

yes

no

&n%5le/+e %) lan+ua+e"< Ra!e 0%ur"el) Excellent, Good, Fair, or Poor' Include all languages that you spea or have studied3 including 'nglish. List your native language also. Lan+ua+e Rea/in+ ?ri!in+ S#ea9in+ Li"!enin+

Lan+ua+e #r%)i$ien$0 If you have ta en any standard test of 'nglish language proficiency +for e/ample %&'FL or I'L%)- please identify the type of test ta en3 give the results3 and provide a copy of the test results. %est %a en> 1ate %a en> Results + attach copy->

E/u$a!i%nal In)%r a!i%n

%ype of Program 'ntrance @ear Current )emester "ccumulative !P" > > > > Re+ular In!erna!i%nal Pr%+ra

#
EXTRA=CURRICULAR ACTI@ITIES (attach evidence if any. Write N N! if you don"t have any) A$!i1i!0 In"!i!u!i%nAOr+ani.a!i%n 8ear Fr% T%

ORGANIBATIONAL ACTI@ITIES ACOMMUNIT8 IN@OL@EMENT (attach evidence if any. Write N N! if you don"t have any) 8ear Na e S#%n"%r P%"i!i%n in Or+ani.a!i%n Fr% T%

SCHOLARSHIPS RECEI@ED (attach evidence if any. Write N N! if you don"t have any) 8ear Na e S#%n"%r Fr% T%

De"$ri#!i%n

9
ACADEMICANON=ACADEMIC ACHIE@EMENTS OR PRIBES (attach evidence if any) Write N N! if you don"t have any) A$*ie1e en! Pla$e (city) 8ear De"$ri#!i%n

Cel%5; #r%1i/e !*e na e"; a//re""e" an/ !ele#*%ne nu :er" %) in/i1i/ual" !% :e n%!i)ie/ in $a"e %) e er+en$0' In/i$a!e rela!i%n !% L%$a!i%n D a//re"" %) in/i1i/ual Lan+ua+e" !*i" Na e %) in/i1i/ual in/i1i/ual 2rela!i1e; #er"%n "#ea9" )rien/; e!$'3

STUDENT EXCHANGE PROGRAM APPLICATION CERTIFICATION STATEMENT

CERTIFICATION< I certify that I completed this application myself3 without aid or assistance3 that the information given in this application is complete and accurate3 and that I have carefully read and understand it. I understand that program administrators reserve the right to verify all the information listed in the application. I understand that giving false or misleading information in the application will eliminate me from the competition or cause my dismissal from the )tudent '/change Program. "lso3 I ac nowledge that I am aware of the following program re0uirements> I must follow all program rules and regulations and observe all the laws of Malaysia during my stay there. "t the end of the year program3 I will return to my home country. I understand that I may not e/tend my stay in Malaysia. AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA )ignature of applicant AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA 1ate +month;day;year-