Universiti Malaysia Pahang Application Form

By | March 15, 2018

Universiti Malaysia Pahang Application Form

Universiti Malaysia Pahang Application Form,below is Universiti Malaysia Pahang Application Form
 
 
APPLICATION FORM
(Please fill in two copies)
THE POST-DOCTORAL SCHEME
UNIVERSITI MALAYSIA PAHANG
SECTION A
PERSONAL PARTICULARS
Name (write in BLOCK LETTERS)
Permanent address: Tel.:
H/P:
E-mail:
Fax:
Mailing address:
Date of birth: Age: Religion:
*Sex: Male / Female Citizenship: Race:
NRIC/Passport no.: *Marital status: Single / Married
ACADEMIC QUALIFICATIONS
(Please enclose scroll and academic transcripts)
Particulars Diploma Bachelor Master Doctorate
Name of certificate
Class/CGPA
Field
Year
Name and place of
Institution attended
*Are you bonded with your sponsor? Yes/No (Please indicate and enclose documentary evidence if any)
Affix the
photograph
English qualification (only for non Malaysian). Please enclose documentary evidence.
TOEFL:
IELTS:
Date and duration (months) if appointment requested Amount of allowance requested (Malaysian Ringgit)
APPLICATION’S DECLARATION
I affirm that all statements made by me on this form are correct. I understand that any inaccurate or false
information or omission of material information will render this application invalid and that, if admitted and
awarded a Post-Doctoral Scholarship on the basis of such information, my candidature can be terminated and I
can also be subject to any penalty in the agreement.
Name:
Signature: Research Project Signature (if applicable):
Date: Date:
SECTION B
SUPERVISOR’S PARTICULARS
(to be completed where applicable)
Name: NRIC (new):
Title of position held: *Status of position held: Permanent / Temporary /
Contract / Assignment / Secondment or others (please
indicate)
Office address: Tel.:
Fax:
E-mail:
Are there any possibilities that you will retire / go for sabbatical leave / be transferred to other places / end your
contract within your supervision period to this applicant?
RESEARCH INFORMATION
Grant title and name of agency / institution of
awardee
Name of programme head or project leader and the
institution where the grant is being paid to
Names of other project members and their respective institutions
Date of grant approval Total amount of grant (Malaysian Ringgit)
Type of research (please ( √ ) in the right box)
Experimental applied research
Prioritised research
Strategic research
Research grant number
Field of research
Project title (main research project)
Please indicate the number of graduate students (post-doctoral / master / doctorate) who are under your
supervision. How many of them are NSF? if any?
Please list out the research plan that the applicant will be attached to (please use extra sheets if the space here
is insufficient)
DECLARATION
I affirm that all statements made by me on this form are correct.
Signature: Date:
Official stamping of name and occupation:
SECTION C
For office use only
i. Dean’s comment: ____________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
Signature: Date:
(Dean, School of ……………….….…)
ii. Deputy Vice-Chancellor Comment: ______________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
Signature: Date:
(Deputy Vice-Chancellor)
iii. Financial Implication: _________________________________________________
__________________________________________________________________
__________________________________________________________________
Signature: ______ ___________ Date:
(Officer In-charge of Academic Staff Recruitment)
iv. Vice-Chancellor’s Approval : ___________________________________________
__________________________________________________________________
Suggestion of appointment of post-doctoral fellow is *approved / rejected:
___________________________________________________________________________
___________________________________________________________________________
Signature: Date: