交换生申请表

更新时间:2023-05-07 09:36:11 阅读：评论：0

(ALL ITEMS MUST BE FILLED)

	SOKONGAN PENGURUSAN PELAJAR DAN STAF ANTARABANGSA PUTRA INTERNATIONAL CENTRE (PUSAT ANTARABANGSA) Kod Dokumen: SOK/INT/BR01/INBOUND
	APPLICATION FOR STUDY IN UPM (INBOUND)

A. APPLICANT / PARTICIPANT PERSONAL DETAILS (COMPULSORY)

Name (Mr./Mrs./Miss)	Plea stick passport sized picture here
Date of Birth		Age
Place of Birth		Race
Gender	Male Female	Marital Status	Married Single
Citizenship/ Nationality		Religion
Passport Number		Mobile Number
E-mail address
Next of kin		Contact number
Home address
State & Country		Postcode

B. EDUCATION AT HOME UNIVERSITY (COMPULSORY)

Current Home University (name & full address)
Phone number		Fax number
E-mail address		University web site
Faculty which applicant is attached to at home university
Degree Programme
Degree Level	Diploma Bachelor Master PhD	Current mester
Current result (CGPA)		Expected year of graduation

C. STUDY IN UPM (COMPULSORY)

Type of Mobility	Exchange Programme (1 or 2 mester with credit transfer) Short Mobility Internship Programme Rearch attachment ASEAN International Mobility for Students (AIMS) Programme ASEAN University Network (AUN) Programme MEVLANA Exchange Protocol University Mobility in Asia and the Pacific (UMAP) Programme Others, plea specify ______________________________________
Faculty / Institute applied in UPM
Does this university have MoU with UPM?	Yes No
Period of study (in UPM)	Commencing _______________________ to __________________________
Plea specify your rearch project (if applicable)
Transfer of credits required (Plea fill in the Transfer of Credit Between Institution – Inbound Form)	Yes No

D. LANGUAGE

Native Language
Language proficiency	English Proficient Moderate Weak Malay Proficient Moderate Weak Others (specify) Proficient Moderate Weak ______________________________________________
English Language Certificate or equivalent (plea attach the document on your application)	IELTS TOEFL Others (specify) _______________________________________________

E. INTER-OFFICE COMMUNICATION (COMPULSORY)

Plea include the contact person from the home university (international affairs officer/student exchange coordinator) who is responsible for correspondence.

Name (Mr. / Miss / Mrs.)
Position
Office/Department
Correspondence address
Phone number		Fax number
E-mail address
Signature & Stamp

F. COURSE INFORMATION FOR TRANSFER OF CREDIT (to be completed by student)
Fill in the cour of the University Putra Malaysia to be taken in the space provided.
No.	Cour Code	Cour Name	Credit

G. ACADEMIC ADVISOR INFORMATION (to be completed by the Dean of the respective universities)

NAME OF HOME INSTITUTION:		UNIVERSITI PUTRA MALAYSIA

Name	:	Name	:
Position	:	Position	:
Email Address	:	Email Address	:

H. TO BE COMPLETED BY DEAN OF FACULTY

I hereby support / not support the application for credit transfer.	I hereby agree to offer the cour requested by the candidate for transfer credit.
HOME INSTITUTION:	UNIVERSITI PUTRA MALAYSIA:
Dean / Deputy Dean's signature and stamp:	Dean / Deputy Dean's signature and stamp:
Date :	Date :

I. Student Declaration

I hereby declare that the information provided in this form is true.

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