Sarawak Biodiversity Centre

Industrial Training Application Form

1. PERSONAL PARTICULARS
Name: __________________________________
NRIC No.: __________________________________
Address: __________________________________ Please attach
passport-
__________________________________ sized
Email Address: __________________________________ photograph
here
Tel. No. (Home): __________________________________
Tel. No. (Mobile) __________________________________

2. TRAINING DETAILS
Name of University:
University Address:
Faculty & Programme:
Name of Co-ordinator:
University/Faculty Tel.:
University/Faculty Fax:
Date of Training:
Duration:
__________________________________________________
__________________________________________________
__________________________________________________
__________________________________________________
__________________________________________________
__________________________________________________
__________________________________________________
Start: ___________________ End: ______________________
_______________ (Weeks)

3. CHECKLIST
Please attach the following documents to this application form:

Application Cover Letter (from faculty)

Complete list of all courses/subjects taken to-date

Copy of Academic Transcript * must be certified true copy

Copy of NRIC (both sides) * must be certified true copy

Passport-sized Photograph * to be attached in Section 1 above

4. TRAINING PROGRAMME PREFERENCE (please mark “X” for the preferred program)

Microbiology Laboratory

Molecular Biology Laboratory

Extraction and Analytical Chemistry Laboratory

Bio-informatics

Traditional Knowledge (TK) Documentation

Public Awareness and Appreciation
Placement is subject to SBC’s discretion and you may not be placed at your most preferred
programme.

SBC-GDL-ADM-0010 Industrial Training Application Form, Rev 1 page 1 of 2

 Sarawak Biodiversity Centre
Industrial Training Application Form

5. EMERGENCY CONTACT
Name of contact : __________________ Relationship : ______________
Tel. (Home/Office) : ___________________ Tel No. (Mobile) : ______________

6. TERMS AND CONDITIONS

(a) This application form must be completed and all the required documents attached.
Applications containing false or incomplete information will be considered void.
(b) Replacements, other than the applicant himself/herself; shall not be accepted.
(c) Allowances, financial support or other monetary compensation will not be provided.
(d) Accommodation and transportation will not be provided.
(e) Insurance coverage and medical protection will not be provided.
(f) Students are required to sign a Waiver Of Liability, Assumption Of Risk And
Indemnity Agreement. SBC shall not be liable for any mishaps or incidents that may
occur to the student during the training period.
(g) Students are required to sign an Intellectual Property Waiver And Recognition Of
Rights Agreement; and to maintain confidentiality of any and all information that
he/she is given access to during the training period.
(h) Students must abide by all SBC administrative procedures. Violations and/or non-
compliance may result in termination of training.

7. DECLARATION
I, ____________________________________ (NRIC No.) ______________________,
hereby declare that all the information submitted in this application form is true; and that I
have read and understood all the terms and conditions stated in Section 6 (a) – (h).

Signature: _____________________________ Date: _____________________

Please mail the completed application form together with the required documents to:
SARAWAK BIODIVERSITY CENTRE
KM20, Jalan Borneo Heights, Semenggoh
Locked Bag No. 3032
93990 Kuching, Sarawak
(Tel) 082-610 610
(Fax) 082-611 535
(Email) biosar@sbc.org.my

SBC-GDL-ADM-0010 Industrial Training Application Form, Rev 1 page 2 of 2