附件二：彭亨大学交换生项目申请表.pdf

C. OTHERS (CO-CURRICULUM ACTIVITIES / SPECIAL SKILLS) Co-curriculum activities : Special skills : D. STUDY IN UMP (COMPULSORY) Faculty / Center applied to in UMP Does your university have MoU with UMP? Yes Type of mobility program No Exchange Programme (1 or 2 semester) Short term Programme (less than 1 semester) • Mobility Program (2 weeks or more) • Short Mobility (7-13 days) • Industrial Training (with credit) Internship Programme (work/research attachment) Visits (less than 7 days) Others, please specify _______________________________________ Period of study (in UMP) 2 semesters 1 semester Others Commencing _______________________ to __________________________ Please describe your research project (if relevant) Proposed site supervisor at UMP : List of equipment required : • • • • • • Transfer of credits required (Please fill in the Academic Transcript Form) Yes No Please specify each course to be taken in UMP: ______________________________________________________________ ______________________________________________________________ E. FINANCIAL INFORMATION (COMPULSORY) How would you intend to finance your programme? Self-sponsored Home Institution Sponsor Please specify details of sponsorships (Sponsoring Body/Institution/Association): ___________________________________________________________________________________ F. LANGUAGE Native Language Language proficiency English Proficient Moderate Weak Malay Proficient Moderate Weak Others (specify) Proficient Moderate Weak ______________________________________________ G. INTER-OFFICE COMMUNICATION (COMPULSARY) Please include the contact person from the home university (international affairs officer/student exchange/mobility coordinator) who is responsible for correspondence. Name (Mr. / Miss / Mrs.) Position Office/Department Correspondence address Phone number Fax number E-mail address I hereby declare that the information provided in this form is true. Signature : ____________________________________ Name : ____________________________________ Date: ________________________ NOTE: Please submit current colored photographs (passport size), a copy of your passport (front page only). For credit transfer program, please enclosed a copy of academic transcript. PART II : To be completed by UMP . RECOMMENDATION BY THE DEAN OF FACULTY / HEAD OF CoE : Comment : (For credit transfer program, Dean is requested to comment on the courses applied by the students) ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------Name : Signature & Stamp : Date: RECOMMENDATION BY THE INTERNATIONAL OFFICE DIRECTOR : Comment : ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------Name : Signature & Stamp : Date: RECOMMENDATION BY THE DEAN OF INSTITUE OF POSTGRADUATE STUDIES (if applicable) : Comment : ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------Name : Signature & Stamp : Date: APPROVAL BY THE DEPUTY VICE CHANCELLOR (ACADEMIC & INTERNATIONAL) / : DEPUTY VICE CHANCELLOR (RESEARCH & INNOVATION) Comment : ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------Name : Signature & Stamp : Date :