Professional Documents
Culture Documents
Nationality:
Date of birth: Age:
E-mail: Contact Number:
Indicate planned research title for PhD (please attach detailed research proposal) :
E. ACADEMIC/PROFESSIONAL EMPLOYMENT
1
F. INVOLVEMENT/EXPERIENCE IN ACADEMIC & NON-ACADEMIC ACTIVITIES
G. PUBLICATION ACTIVITIES
Indicate your publications details in journals. Please indicate details and proof where needed
Articles Published (reference format) ISI/Scopus Impact factor
Listings/Others
H. RESEARCH EXPERIENCE
Indicate your previous experience in research
Research undertaken Institution & Country Date
I. REFEREES : Indicate names address and contact details of a senior researcher/supervisor familiar with applicant’s work; their
reference letter must be letter-headed, signed and submitted to USM. There is no standard format. If sent by email, it should be a
scanned copy. The letter can be submitted either by the referee of by the applicant directly with this form.
Name:
Organisation:
Contact Number: Fax: E-mail:
Relationship to candidate:
2
ENCLOSURES CHECKLIST
Important ; Please ensure that ALL relevant enclosures are included with the completed application form
Please only submit the material requested as any other material not listed is not required (e.g secondary
education certificates, certificates of participation in conference or training courses etc)
Passport size photograph
A copy of passport (if any) for non Malaysian applicant or ID. Only the first page with personal
details is required
Research Proposal
Proof of publication in journals (provide link if available on website)
Certified copies of University degree certificates and relevant university transcripts for all
academic degrees
Certified copy of IELTS/TOEFL 9if any)
Certificate of good health from a qualified medical doctor
OTHER INFORMATION
How did you find out about USM Global Fellowship?
Institute of Postgraduate Studies, Universiti Sains Malaysia’s website
Word of mouth/email from colleague
Newspaper
Recommendation of supervisor
Postgraduate Exhibitions / Student Recruitment Activities
Postgraduate Talks / Seminars
Others (please specify)
SUBMISSION GUIDELINES
For submission of application Please save the completed application form as an MS Word
by e-mail document with both your name and the Fellowship’s acronym in its
file name. Example: If your name is Ahmed Abu, name the file
“AHMED_USMGF.doc” as appropriate.