Official Portal of UKM



PERMOHONAN HENDAKLAH DISERTAKAN BERSAMA DOKUMEN SEPERTI BERIKUT:

THE FOLLOWING DOCUMENTS MUST BE ATTACHED TO APPLICATION:

| |DOKUMEN |TANDAKAN (√) |

|BIL |DOCUMENT |PLEASE TICK (√) |

|NO | | |

| | |PEMOHON |Pusat Siswazah |

| | |APPLICANT |Graduate Centre |

|1. |1 keping gambar berukuran pasport | | |

| |1 passport sized photograph | | |

|2. |Salinan Kad Pengenalan/Pasport (disahkan benar dari salinan asal) | | |

| |Copy of Identity card/Passport (certified true copy) | | |

|3. |Salinan Transkrip Akademik Sarjana Muda dan Sarjana (disahkan benar dari salinan asal)| | |

| |Certificate copies of academic transcripts Bachelor Degree and Master Degree | | |

| |(certified true copy) | | |

|4. |Muka hadapan artikel yang telah diterbitkan | | |

| |Front page of the published articles | | |

|5. |Muka hadapan permohonan kemasukan ke UKM secara atas talian | | |

| |Front page of the UKM online Application Form | | |

|6 |Cadangan penyelidikan | | |

| |Research proposal | | |

|7. |Huraikan secara ringkas mengapa UKM perlu memilih anda untuk biasiswa ini | | |

| |Briefly describe why UKM should choose you for this scholarship | | |

|8. |Curriculum Vitae | | |

Borang yang telah lengkap diisi serta dokumen yang diperlukan hendaklah dihantar kepada:

Completed form and required documents must be submitted to :

Pengarah / Director

Pusat Siswazah UKM/ The UKM Graduate Centre

Universiti Kebangsaan Malaysia

43600 UKM Bangi, Selangor Darul Ehsan,

Malaysia.

e-mail: awardsandscholarship@ukm.edu.my

|BAHAGIAN A / SECTION A : |

|BUTIRAN DIRI PEMOHON / PERSONAL INFORMATION OF APPLICANT |

| |

|Nama (dalam huruf besar) / Name (in capital letters) : |

| |

| |

| |

|Tarikh Lahir : No. Matrik : |

|Date of Birth Matric No |

| |

|No. Kad Pengenalan / Pasport : Umur : |

|Identity Card No. / Passport No. Age |

| |

|Warganegara : Jantina : |

|Nationality Gender |

| |

|Negara Asal : |

|Origin Country |

| |

|Taraf perkahwinan : |

|Maritial status |

| |

|Fakulti : Jabatan : |

|Faculty Department |

| |

|Sesi/Semester yang Dipohon: |

|Session/Semester Applied for |

|eg: 2020/2021 (Semester 1) |

| |

|Jenis Program : Jenis Pengajian : |

|Programmes Type of study |

| |

|Bidang pengajian : Tempoh pengajian : |

|Field of study Duration of Study |

| |

|Nama Penyelia (jika ada) : |

|Supervisor (if any) |

| |

|Tajaan lain (jika ada) : |

|Sponsorship (if any) |

| |

|Alamat : |

|Address |

| |

| |

| |

| |

|Poskod : Negeri : |

|Postcode State |

| |

|No. Telefon : |

|Telephone No. |

| |

|Emel : |

|Email |

| |

|BAHAGIAN B/ SECTION B : |

|BUTIRAN KULULUSAN AKADEMIK / ACADEMIC QUALIFICATION |

| | | |

|Butiran |Sarjana Muda |Sarjana |

|Information |Bachelor |Master |

| | | |

| | | |

| | | |

|Nama Ijazah | | |

|Name of Degree | | |

| | | |

| | | |

| | | |

|Kelas/PNGK | | |

|Class/CGPA | | |

| | | |

| | | |

|Bidang | | |

|Specialization | | |

| | | |

| | | |

|Tahun | | |

|Year | | |

| | | |

| | | |

|Nama Universiti | | |

|Name of the University | | |

| |

|BAHAGIAN C/ SECTION C : |

|SENARAI PENERBITAN / LIST OF PUBLICATIONS |

|Artikel Jurnal/ Journal Articles |

| | | | | |

|Bil |Pengarang/ Authors |Tajuk/ Title |Maklumat Jurnal/ Journal Information |Faktor Impak Wos Dan |

|No | | |(Nama Jurnal, Nombor Jilid & Halaman/ |Kuartil Jurnal/ Wos |

| | | |Journal Name, Volume Number & Page |Impact Factor And |

| | | |Number) |Journal Quartile |

| | | | | |

| | | | | |

| | | | | |

| | | | | |

| | | | | |

| | | | | |

| | | | | |

| |

|Lain-Lain Penerbitan/ Other Publications |

| |

| |

| |

|BAHAGIAN D / SECTION D : |

|PENGADIL AKADEMIK / ACADEMIC REFEREES |

| |

|SENARAIKAN DUA (2) PENGADIL AKADEMIK |

|LIST TWO (2) OF ACADEMIC REFEREES |

| |

|Senaraikan dua (2) pengadil akademik untuk menyokong permohonan anda |

|Provide two (2) academic referees to support your application |

| |

|Nama: |

|Name |

| |

|Jawatan: |

|Position |

| |

|Alamat: |

|Address |

| |

|No. Telefon: |

|Telephone No. |

| |

|Alamat Emel: |

|Email Address |

| |

| |

| |

| |

|Nama: |

|Name |

| |

|Jawatan: |

|Position |

| |

|Alamat: |

|Address |

| |

|No. Telefon: |

|Telephone No. |

| |

|Alamat Emel: |

|Email Address |

| |

| |

| |

|BAHAGIAN E / SECTION E : |

|PERAKUAN DAN PENGESAHAN PEMOHON |

|DECLARATION AND CONFIRMATION BY APPLICANT |

| |

|PERAKUAN PELAJAR/ APPLICANT DECLARATION |

| |

|Saya akui telah membaca dan memahami semua maklumat dan dokumentasi yang dimuatkan dalam borang permohonan dalam pengetahuan saya adalah benar |

|dan lengkap. Saya faham bahawa sebarang maklumat yang didapati palsu akan menyebabkan permohonan ini ditolak. Jika saya ditawarkan dan diterima |

|dalam Biasiswa Naib Canselor UKM ini, saya bersetuju mematuhi peraturan Universiti Kebangsaan Malaysia. |

| |

|I, the undersigned, declare that I have read and understand that all information and documentation provided in the application are, to the best |

|of my knowledge, correct and complete. I understand that any false statement or omission, even if unintended on my part may result a rejection |

|of my application. Finally, if I am offered and accepted to enroll in the UKM Vice-Chancellor Scholarship Fund, I agree to abide by the rules |

|and regulations of University. |

| |

| |

|Tandatangan Pemohon / Applicant Signature: Tarikh / Date: |

| |

| |

Tamat / End

-----------------------

Berkahwin

Married

Bujang

Single

Sarjana

Master

Doktor Falsafah

Doctor of Philosphy

................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download