SALINAN UPM ET

UPM/TNCAA/PS/PPL-01
PEJABAT TIMBALAN NAIB CANSELOR
(AKADEMIK DAN ANTARABANGSA)

APPLICATION FOR ADMISSION

PHOTO
(Reminder : Incomplete forms and/or documents will not be processed)

1. DETAILS OF PROGRAMME

a) First choice programme: MASTER OF HUMAN RESOURCE DEVELOPMENT

b) Learning centre: UNIVERSITI PUTRA MALAYSIA

c) Second choice programme: MASTER OF CORPORATE COMMUNICATION

d) Learning centre: UNIVERSITI PUTRA MALAYSIA

e) Provide the name of potential advisor / supervisor if already identified:

f) Preferred Semester for Enrollment: SECOND PPL SEMESTER 2020/2021

2. PERSONAL DETAILS

Full Name: MOHD AIZAM BIN SIMAN

IC/Passport No: 860824125173 Date of Birth: 24 AUGUST 1986 Place of Birth (State/Country): SABAH

Race/Etnic: BUMIPUTERA SABAH Nationality: MALAYSIA Religion: ISLAM

Sex: MALE Marital Status: MARRIED

Telephone No: 0139124617 Hp. No: Fax No:

E-mail Address: super_ijam86@yahoo.com

Correspondence Address: KAMPUNG SKIM PAMALAN

PETI SURAT 2634
89008 KENINGAU
SABAH
3. EDUCATIONAL BACKGROUND

Degree Year In Achievement

Name of University/College
Awarded Admission Graduation English? (CGPA/%)

UNIVERSITI MALAYSIA BACHELOR OF 2006 2009 YES 3.15

TERENGGANU ECONOMICS
(NATURAL
RESOURCES)
HONOURS

No. Isu:02
No. Semakan:01
Tarikh Kuatkuasa:15/06/2009
1/3
 4. RELATED WORKING EXPERIENCE

Position Held Name and Address of Employer Date

From To
EKSEKUTIF HASIL LEMBAGA HASIL DALAM NEGERI 01-FEB-12 01-AUG-46
MALAYSIA CAWANGAN KENINGAU
PETI SURAT 1721,
KENINGAU, SABAH.

5. FINANCIAL SUPPORT

PEMBIAYAAN SENDIRI(SELF-FINANCED)

6. ENGLISH LANGUAGE PROFICIENCY

EXAMINATION RESULT

TOEFL -
IELTS -

Have not been admitted to universities/institutions for any graduate programme before.

7. CERTIFICATION
_________________________________________________________________________________________

I certify that the information given in this application is correct. If this application is incomplete or information given is
incorrect, UPM has the right to reject the application or withdraw offer of admission.

Signature of Applicant: ___________________ Date:________________

No. Isu: 02
No. Semakan: 01
Tarikh Kuatkuasa: 15/06/2009 2/3
 Name : MOHD AIZAM BIN SIMAN IC/Passport : 860824125173

8. CHECK LIST FOR APPLICANT

Please enclose the following items in order for your application to be processed. Documents submitted is
not returnable.

a) Completed application form PPL-01

b) Report from two referees - from PPL-01 (Attachment) (in sealed envelope and with signature across it)

c) Certified copy of degree certificates

d) Certified copy of examination transcript (Bachelor Level)

e) Certified copy of identity card

f) Payment can be made through CIMB Bank Account No: 8002167906,Account Name: UPM EDUCATION
& TRAINING SDN. BHD.
g) CIMB Bank Berhad cash deposit slip (RM50.00).Please jotted down full name and identity card no at the
back of cash deposit slip.
h) Certified photocopy of letter of scholarship / sponsorship award (if any) or pay slip of applicant / guardian

i) All documents attached must be certified by recognized authorities

j) All supporting documents that are in other than English or Malay language must be with certified English
translation

Please send applications to :

UPM EDUCATION & TRAINING SDN BHD

BLOK D UPM-MTDC TECHNOLOGY CENTRE
UNIVERSITI PUTRA MALAYSIA
43400 UPM SERDANG
SELANGOR DARUL EHSAN, MALAYSIA

NOTE:
. Incomplete forms and/or documents will not be processed.

. The deadlines for submitting applications for graduate studies are :

Local applicant : 31 DECEMBER 2020

International applicant : 27 DECEMBER 2020

. Applications received after these dates will only be considered for the following semester.

. The above dates are subject to change. Please visit www.ppl.upm.edu.my for updates.

No. Isu: 02
No. Semakan: 01
Tarikh Kuatkuasa: 15/06/2009 3/3