APPLICATION FOR ADMISSION TO UTAR AS NON GRADUATING STUDENT by liaoqinmei

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									                                   Universiti Tunku Abdul Rahman
                                   APPLICATION AS A NON-GRADUATING STUDENT
                                          (for UTAR Students only)

1. PERSONAL PARTICULARS

Name

Faculty/Institute                                              Programme
                                                               Registration
Level of Study        Bachelor / Master / PhD*
                                                               No.
I.C. No.                                                       Tel.


Postal Address                                                 Email

*Delete whichever not applicable

2. INFORMATION ON HOST INSTITUTION (if available)
Name of Host
Institution

Address

Contact Person                                                 Designation

Tel.                                                           Email

3. PERIOD OF STUDY AT HOST INSTITUTION

Tick the appropriate box to indicate the period.
           One Trimester                                               Two Trimesters
           Duration: __________________________                        Duration: ___________________________

           One Academic Year                                           Other
           Duration: __________________________                        Duration: ___________________________

4. CHOICE OF UNITS
List below details of the units you intend to study at host institution.
   Unit Code                  Unit Description                   No. of         Credit     For Official Use Only
                                                                 Credit       Transfer ^   Comments by Dean
                                                                 Hours        (Yes/No)
 For Industrial Attachment Only
 Name of
 Faculty/School/Institute/Centre
 Supervisor at Host Institution

Research Topic (if applicable): ______________________________________________________________

_______________________________________________________________________________________

^Please take note that you are required to obtain prior approval from University (UTAR) before
commencement of your study at the host institution if the above units will be used for credit transfer purposes
in UTAR. Otherwise, please apply for leave of absence for the duration of study at the host institution.

5. SOURCE OF FUNDS
Parents/Sponsor/Scholarship/Fellowship/Self-Financing*
If you are sponsored or awarded a scholarship/fellowship, please indicate:

Name of Award/Sponsor                 ________________________________________________________

Duration and Amount of Award          ________________________________________________________

Signature of
                                                           Date
Applicant

  Please return completed application form to:

                     Department of Internationalisation and Institutional Relations
                                     Universiti Tunku Abdul Rahman
                                       No. 9, Jalan Bersatu 13/4,
                                    46200 Petaling Jaya, MALAYSIA

                                           For Office Use Only

Collection of Completed Form by Department of Internationalisation and Institutional Relations

Collected By                                               Date

Approval by Dean/Director of Faculty/Institute


        Approved                                                  Not Approved


Remarks

Signature                                                  Date

								
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