UKM/PPPS/C/P02/AK06/01

Tarikh Kuatkuasa: 13-02-2017

PUSAT PENGURUSAN AKADEMIK

Centre For Academic Management

PERMOHONAN PENANGGUHAN PENDAFTARAN MASUK

Deferment of Admission Application

Maklumat Diri Pelajar

Student’s Details

Nama (Name): Puteri Nelissa Milani binti Abdullah Kamil

No. Pendaftaran
(Registration Number)
Program Pengajian
(Program of Study)
Fakulti/Institut:
Faculty/Institute:
Sem/sesi ditawarkan:
Semester/session offered:
Sem/Sesi ingin mendaftar:
Semester/session to register:

Alamat surat – menyurat:

Correspondence address :

No. Telefon
(Telephone number)
Mel – e (E-mail)

Sebab penangguhan:
(Reason of deferment)

PERINGATAN : MAKSIMUM PENANGGUHAN ADALAH DUA (2) SEMESTER SAHAJA.

REMINDER : Maximum of deferment is only two (2) semesters.

Tandatangan :__________________________ Tarikh: _______________________________

(Signature) (Date)

[*Potong yang tidak berkenaan (* Delete where not applicable)]