PU/S/BR04/GS-17

PEJABAT TIMBALAN NAIB CANSELOR

No. Matrik (Matric No.)

MAKLUMAT UNTUK BERGRADUAT
PARTICULARS FOR GRADUATION
JM40782

Nama (Name) : SANDARA A/P MUNIANDY

Program (Programme) : MASTER OF MALAY LANGUAGE
Bidang Pengajian (Field of Study) : MALAY LANGUAGE
Fakulti/Institut (Faculty/Institute) : FACULTY OF MODERN LANGUAGES AND COMMUNICATION

Alamat surat-menyurat semasa/di Malaysia :

(Current correspondence address/in Malaysia)

SJKT LADANG KOMBOK No. Telefon (Telephone No.) : 0167134624

RANTAU, No. Faks (Fax No.) :
81300 SEREMBAN E-mel (E-mail) : sandara08@gmail.com

YURAN BERGRADUAT (GRADUATION FEES) :

Saya telah membayar Yuran Bergraduat sebanyak RM200.00

(I have paid the Graduation Fees in the amount of RM200.00)

No. Resit (Receipt No.) : 408117559

Sila dapatkan pengesahan Bendahari bagi bayaran semua yuran. Pelajar dikehendaki
membawa resit asal bayaran yuran ke Pejabat Bendahari
(Please get confirmation of payment of all fees from the Bursar's Office. You are required to
bring your original receipt of payment)

Tandatangan pelajar
(Signature of student)

Tarikh (Date) : 04-OCT-16 Tarikh (Date) : 04-OCT-16

PENGESAHAN BENDAHARI (ENDORSEMENT OF THE BURSAR) :

Adalah disahkan bahawa pelajar ini telah menjelaskan semua yuran termasuk
Yuran Bergraduat seperti yang dinyatakan di atas
(It is certified that this student has paid all fees including the Graduation Fees as
stated above)

Tandatangan dan cap rasmi pegawai

Tarikh (Date) : (Signature and official stamp of officer)

PENGESAHAN PERPUSTAKAAN (ENDORSEMENT OF THE LIBRARY)

Adalah disahkan bahawa pelajar ini telah memulangkan semua buku

(It is certified that this student has returned all books)

Tarikh (Date) : Tandatangan dan cap rasmi pegawai

(Signature and official stamp of officer)

[ Salinan Sekolah Pengajian Siswazah (School of Graduate Studies's Copy) ]

NO. SEMAKAN: 00
NO. ISU: 02
TARIKH KUAT KUASA: 03/01/2011 1 drp. 2
 PU/S/BR04/GS-17
PEJABAT TIMBALAN NAIB CANSELOR
(AKADEMIK DAN ANTARABANGSA)

No. Matrik (Matric No.)

MAKLUMAT UNTUK BERGRADUAT
PARTICULARS FOR GRADUATION
JM40782

Nama (Name) : SANDARA A/P MUNIANDY

Program (Programme) : MASTER OF MALAY LANGUAGE
Bidang Pengajian (Field of Study) : MALAY LANGUAGE
Fakulti/Institut (Faculty/Institute) : FACULTY OF MODERN LANGUAGES AND COMMUNICATION

Alamat surat-menyurat semasa/di Malaysia :

(Current correspondence address/in Malaysia)

SJKT LADANG KOMBOK No. Telefon (Telephone No.) : 0167134624

RANTAU, No. Faks (Fax No.) :
81300 SEREMBAN E-mel (E-mail) : sandara08@gmail.com

YURAN BERGRADUAT (GRADUATION FEES) :

Saya telah membayar Yuran Bergraduat sebanyak RM200.00

(I have paid the Graduation Fees in the amount of RM200.00)

No. Resit (Receipt No.) : 408117559

Sila dapatkan pengesahan Bendahari bagi bayaran semua yuran. Pelajar dikehendaki
membawa resit asal bayaran yuran ke Pejabat Bendahari
(Please get confirmation of payment of all fees from the Bursar's Office. You are required to
bring your original receipt of payment)

Tandatangan pelajar
(Signature of student)

Tarikh (Date) : 04-OCT-16 Tarikh (Date) : 04-OCT-16

PENGESAHAN BENDAHARI (ENDORSEMENT OF THE BURSAR) :

Adalah disahkan bahawa pelajar ini telah menjelaskan semua yuran termasuk
Yuran Bergraduat seperti yang dinyatakan di atas
(It is certified that this student has paid all fees including the Graduation Fees as
stated above)

Tandatangan dan cap rasmi pegawai

Tarikh (Date) : (Signature and official stamp of officer)

PENGESAHAN PERPUSTAKAAN (ENDORSEMENT OF THE LIBRARY)

Adalah disahkan bahawa pelajar ini telah memulangkan semua buku

(It is certified that this student has returned all books)

Tarikh (Date) : Tandatangan dan cap rasmi pegawai

(Signature and official stamp of officer)

[ Salinan Pelajar (Student's Copy) ]

NO. SEMAKAN: 00
NO. ISU: 02
TARIKH KUAT KUASA: 03/01/2011 2 drp. 2
 PERKHIDMATAN UTAMA
SISWAZAH

PEJABAT TIMBALAN NAIB CANSELOR (AKADEMIK & ANTARABANGSA)

Kod Dokumen: PU/S/BR04/GS-17c
BORANG PERMOHONAN DOKUMEN BERGRADUAT
(GRADUATE DOCUMENT REQUEST FORM)

1. MAKLUMAT PELAJAR (DETAILS OF STUDENT)

Nama (Name) : SANDARA A/P MUNIANDY

No. Matrik (Matric No.) : JM40782
Fakulti / Institut (Faculty/Institute) : FACULTY OF MODERN LANGUAGES AND COMMUNICATION
Program (Programme) : MASTER OF MALAY LANGUAGE
No. Telefon (Telephone No.) : 0167134624

2. AKUAN PELAJAR (DECLARATION BY STUDENT)

Sila tandakan pada kotak berkenaan. (Please tick the appropriate box) :

Saya, dengan ini mengaku akan hadir Majlis Konvokesyen. (I declare that I will attend the convocation).

Saya akan mengambil sendiri surat senat, transkrip dan sijil. (I, will personally collect the Senate letter,
transcript and certificate).

Saya wakilkan penama di bawah untuk mengambil surat senat, transkrip dan sijil bagi pihak saya, dan
segala risiko ditanggung oleh saya sendiri. (The name below will represent me to collect the Senate letter,
transcript and certificate. I am responsible for any risks due to this decision.)

Nama (Name):
No. Matrik atau No. KP/ Pasport
(Matric no. or IC / Passport No.):
No. Telefon (Telephone No.):

Saya memahami bahawa Sijil diberi sekali sahaja (I fully understand that the certificate will only be issued once).

Tandatangan pelajar (Signature of student): Tarikh (Date):

Catatan: Sila pulangkan sijil asal dua versi sebelum mengambil pakaian akademik
(Note: Please return the two versions of the certificates before taking the academic regalia).

UNTUK KEGUNAAN PEJABAT (FOR OFFICE USE)

Disahkan bahawa pemohon ini telah menerima semua dokumen bergraduat.

Tandatangan Pegawai dan Cap Rasmi: Tarikh:

NO. SEMAKAN: 00
NO. ISU: 02
TARIKH KUAT KUASA: 14/08/2012 1 drp. 1