APPLICATION FOR PAPER PRESENTATION

L/2 FORM

BUDGET
UTP GRANT

IMPORTANT CHECKLIST: Please attach the following documents to support your application.
Office
1. Correct spelling of Universiti Teknologi PETRONAS on the paper
2. Brochure of conference
3. Paper acceptance & corrections from the conference
4. Index Proof (print from SCOPUS/ISI/ERA database)
5. Turnitin report (≤ 20%)
6. Author’s Contribution Form (please attach if authors more than 5)
7. Approval Utilisation of Grant Allocation from RMC (print from RMS Online System) Applicable if the paper is
8. Acknowledgement to the funder using research grant

PLEASE COMPLETE THIS FORM.

PERSONAL DETAILS
Name Staff No Designation Department

PROGRAMME DETAILS
Title of ISID 2018
The 4th International Symposium on Infrastructure Development
Conference
Secretariat Dr. M. Isran Ramli Location
Mrs. Febriane P. Makalew
isid.manado@gmail.com Manado, Indonesia
Address Civil Engineering Department &
Environmental Engineering Department
Hasanuddin University Date
Tel/Fax +6281242441126 / +6282393047359 October 12-14, 2018

ESTIMATED EXPENDITURE FOR ATTENDING CONFERENCE

Description Amount Remarks
1. Conference Fee USD 100.00
2. Transportation
3. Meal Allowance
4. Accommodation (hotel, lodging)
5. Others
TOTAL
 AUTHORSHIP CERTIFICATION:
I/We hereby certify that the work submitted is in full accordance to the Authorship Policy of
Universiti Teknologi PETRONAS and agree on the author order as listed in the manuscript.
Author Name Author’s signature Date
1 Ng Cheng Yee

2 Adida Johan

3 Alex Elpianto Kajuputra

4 Ligar Anggara Pangestu

Disclaimer:
Authorship
An author is generally considered to be an individual or a group who has made substantial intellectual contributions in the:
1. Conception and design, or analysis and interpretation of data, AND
2. Drafting the articles or revising it critically for intellectual content AND
3. Final approval of the version to be published.

Certification:
The senior or corresponding author is required to certify that all listed authors qualify for authorship according to the above criteria.
The author(s) should also certify that no part of the work described has been published before ort under consideration for publication
elsewhere.

Conflict of Interest:
All authors must disclose any affiliation with or receiving any financial support from any organization with a direct financial interest in
the subject matter or materials discussed in the manuscript. All funding sources supporting the work and all institutional or corporate
affiliations are to be acknowledged in a footnote or acknowledgement section.

APPROVAL
CERTIFIED BY ENDORSED BY APPROVED / REJECTED

HEAD OF DEPARTMENT DVC ACADEMIC / DVC RIO VICE CHANCELLOR

Date: Date: Date: