SENARAI SEMAK PERMOHONAN (APPLICATION CHECK...

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Tarikh dikuatkuasa mulai : 18 April 2016 (Effective : April 18, 2016) Institute of Diplomacy and Foreign Relations (IDFR) Mengilham Harapan, Mencipta Masa Depan Ministry of Foreign Affairs Inspiring Futures, Nurturing Possibilities Malaysia SENARAI SEMAK PERMOHONAN (APPLICATION CHECK LIST) TANDAKAN BAGI PERKARA-PERKARA YANG DISERTAKAN DALAM RUANG YANG DISEDIAKAN (PLEASE TICK IN THE COLUMN FOR THE DOCUMENTS ENCLOSED) NO. DOKUMEN-DOKUMEN YANG DIPERLUKAN ADMINISTRATIVE (DOCUMENTS REQUIRED) USE A. Dokumen Utama/Main Documents Yuran permohonan sebanyak RM20.00 (Bagi pemohon warganegara Malaysia) atau USD30.00 (Pemohon luar negara) berbentuk Wang Pos/ Kiriman Wang (atas nama Bendahari UKM) atau dimasukkan ke dalam akaun CIMB Bank UKM No. 1218-0005004-05-8. Sertakan salinan 1. Slip Wang Tunai Masuk). [Application fee of RM20.00 (for Malaysian applicants), or USD30.00 (for Foreign applicants) in a bank draft payable to Benda hari UKM or deposited to account No. 1218-0005004-05-8 (CIMB Bank Berhad). Please enclose the deposit slip] DUA [2] keping kad pengesahan penerimaan beserta setem 2. TWO [2] acceptance notification cards with stamps included DUA [2] salinan borang permohonan yang lengkap diisi dan bertandatangan serta dilekatkan gambar terbaru berukuran pasport 3. (pada tiap-tiap borang) TWO [2] application forms, completed, signed and attached with recent passport-size photographs on each form 4. DUA [2] salinan surat bantuan kewangan daripada penaja atau surat jaminan kewangan daripada DUA [2] penjamin TWO [2] completed financial support forms from TWO [2] financial guarantors 5. DUA [2] salinan borang sokongan daripada Penyokong (1) TWO [2] completed forms from Referee (1) 6. DUA [2] salinan borang sokongan daripada Penyokong (2) TWO [2] completed forms from Referee (2) B. Dokumen Sokongan/Supporting Document 7. DUA [2] salinan Kad Pengenalan (bagi pemohon warganegara Malaysia) atau Pasport (bagi pemohon luar negara) TWO [2] copies of Identification Cards (for Malaysian applicants) or passports (for foreign applicants) 8. DUA [2] salinan sarjana, ijazah dan diploma yang disahkan TWO [2] certified copies of masters, undergraduate and/or diploma qualifications DUA [2] salinan transkrip rasmi ijazah dan diploma yang disahkan 9. TWO [2] certified copies of official transcripts of item(s) 8 10. DUA [2] salinan keputusan IELTS/TOEFL (bagi pemohon luar negara) TWO [2] copies of IELTS/TOEFL results (for foreign applicants) 11. DUA [2] salinan surat tajaan/biasiswa (bagi pemohon yang mendapat tajaan/biasiswa sahaja) TWO [2] copies of sponsorship/scholarship letters (for applicants with sponsorhip/scholarship only) DUA [2] salinan cadangan tesis bagi jenis pengajian secara penyelidikan tesis sahaja- Sarjana 1,000 - 1,500 perkataan, 12. Doktor Falsafah 1,500 - 2,000 (Tidak perlu bagi program secara kerja kursus, atau kerja kursus dan tesis, atau diploma) TWO [2] copies of research proposal for research/by thesis programme only - 1,000 -1,500 words for Masters programme, 1,500-2,000 words for PhD programme (not required for programmes by course work, or programmes by course work and thesis, or diploma programmes) PERHATIAN (REMINDER): Sila susun kesemua dokumen No. 7 hingga 12 kepada DUA [2] set. (Please arrange items No. 7 to 12 in TWO [2] sets) ________________________________ Pengesahan Penerimaan Borang permohonan Acceptance Verification of the Application Form COMPETENCY ENHANCEMENT CENTRE INSTITUTE OF DIPLOMACY AND FOREIGN RELATIONS (IDFR) MINISTRY OF FOREIGN AFFAIRS, MALAYSIA For International Applicants Only Verification Letter from Malaysia’s Embassy/High Commission/Consulate nearest to the applicant 13 Verification Letter from the Embassy/ High Commission/ Consulate of the country of the applicant in Kuala Lumpur 14

Transcript of SENARAI SEMAK PERMOHONAN (APPLICATION CHECK...

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Tarikh dikuatkuasa mulai : 18 April 2016 (Effective : April 18, 2016)

Institute of Diplomacy and Foreign Relations (IDFR) Mengilham Harapan, Mencipta Masa Depan Ministry of Foreign Affairs Inspiring Futures, Nurturing Possibilities Malaysia

SENARAI SEMAK PERMOHONAN (APPLICATION CHECK LIST)

TANDAKAN √ BAGI PERKARA-PERKARA YANG DISERTAKAN DALAM RUANG YANG DISEDIAKAN (PLEASE TICK √ IN THE COLUMN FOR THE DOCUMENTS ENCLOSED) NO. DOKUMEN-DOKUMEN YANG DIPERLUKAN ADMINISTRATIVE

(DOCUMENTS REQUIRED) USE

A. Dokumen Utama/Main Documents Yuran permohonan sebanyak RM20.00 (Bagi pemohon warganegara Malaysia) atau USD30.00 (Pemohon luar negara) berbentuk Wang Pos/ Kiriman Wang (atas nama Bendahari UKM) atau dimasukkan ke dalam akaun CIMB Bank UKM No. 1218-0005004-05-8. Sertakan salinan

1. Slip Wang Tunai Masuk).

[Application fee of RM20.00 (for Malaysian applicants), or USD30.00 (for Foreign applicants) in a bank draft payable to Benda hari UKM or deposited to account No. 1218-0005004-05-8 (CIMB Bank Berhad). Please enclose the deposit slip] DUA [2] keping kad pengesahan penerimaan beserta setem

2. TWO [2] acceptance notification cards with stamps included DUA [2] salinan borang permohonan yang lengkap diisi dan bertandatangan serta dilekatkan gambar terbaru berukuran pasport

3. (pada tiap-tiap borang)

TWO [2] application forms, completed, signed and attached with recent passport-size photographs on each form

4. DUA [2] salinan surat bantuan kewangan daripada penaja atau surat jaminan kewangan daripada DUA [2] penjamin

TWO [2] completed financial support forms from TWO [2] financial guarantors

5. DUA [2] salinan borang sokongan daripada Penyokong (1)

TWO [2] completed forms from Referee (1)

6. DUA [2] salinan borang sokongan daripada Penyokong (2)

TWO [2] completed forms from Referee (2) B. Dokumen Sokongan/Supporting Document

7. DUA [2] salinan Kad Pengenalan (bagi pemohon warganegara Malaysia) atau Pasport (bagi pemohon luar negara)

TWO [2] copies of Identification Cards (for Malaysian applicants) or passports (for foreign applicants)

8. DUA [2] salinan sarjana, ijazah dan diploma yang disahkan

TWO [2] certified copies of masters, undergraduate and/or diploma qualifications DUA [2] salinan transkrip rasmi ijazah dan diploma yang disahkan

9. TWO [2] certified copies of official transcripts of item(s) 8

10. DUA [2] salinan keputusan IELTS/TOEFL (bagi pemohon luar negara)

TWO [2] copies of IELTS/TOEFL results (for foreign applicants)

11. DUA [2] salinan surat tajaan/biasiswa (bagi pemohon yang mendapat tajaan/biasiswa sahaja)

TWO [2] copies of sponsorship/scholarship letters (for applicants with sponsorhip/scholarship only) DUA [2] salinan cadangan tesis bagi jenis pengajian secara penyelidikan tesis sahaja- Sarjana 1,000 - 1,500 perkataan,

12. Doktor Falsafah 1,500 - 2,000 (Tidak perlu bagi program secara kerja kursus, atau kerja kursus dan tesis, atau diploma)

TWO [2] copies of research proposal for research/by thesis programme only - 1,000 -1,500 words for Masters programme, 1,500-2,000 words for PhD programme (not required for programmes by course work, or programmes by course work and thesis, or diploma programmes)

PERHATIAN (REMINDER): Sila susun kesemua dokumen No. 7 hingga 12 kepada DUA [2] set. (Please arrange items No. 7 to 12 in TWO [2] sets)

________________________________ Pengesahan Penerimaan Borang permohonan

Acceptance Verification of the Application Form COMPETENCY ENHANCEMENT CENTRE

INSTITUTE OF DIPLOMACY AND FOREIGN RELATIONS (IDFR) MINISTRY OF FOREIGN AFFAIRS, MALAYSIA

For International Applicants Only

Verification Letter from Malaysia’s Embassy/High Commission/Consulate nearest to the applicant 13

Verification Letter from the Embassy/ High Commission/ Consulate of the country of the applicant in Kuala Lumpur 14

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KAD PENGESAHAN PENERIMAAN

PERMOHONAN MENGIKUTI PROGRAM PENGAJIAN SISWAZAH Sila Lekatkan

(DOKTOR FALSAFAH/SARJANA/DIPLOMA PASCASISWAZAH/DIPLOMA SISWAZAH/TANPA IJAZAH) Setem 50 Sen

SEMESTER __________________ SESI _____________ Di Sini

ACKNOWLEDGEMENT OF RECEIPT Please attach

THE APPLICATION FOR ADMISSION INTO THE GRADUATE STUDIES PROGRAMME 50 Cents Stamp

(PHD/MASTERS/POSTGRADUATE DIPLOMA/GRADUATE DIPLOMA/NON-GRADUATE) Here

(Oversea's Application

SEMESTER ___________________OF THE ______________ SESSION

Excluded)

Kepada (To)

Diisi oleh pemohon (To be filled in by applicant) NAMA PEMOHON / (NAME OF APPLICANT) NO KAD PENGENALAN/NO. PASPORT (Baru) / PASSPORT NO./IC NO. (New)

Diisi oleh pemohon (To be filled in by applicant)

UNTUK KEGUNAAN PEJABAT SAHAJA / FOR OFFICE USE ONLY

PUSAT PEMERKASAAN KOMPETENSI (COMPETENCY ENHANCEMENT CENTRE)

Tuan/Puan Tarikh :

Sir/Madam Date

Permohonan Untuk Memasuki Program Pengajian Siswazah Sarjana Sains Sosial (Strategi dan Diplomasi) Application for Graduate Studies Programme Master of Social Sciences (Strategy and Diplomacy) Bagi Semester dan Sesi

: For Semester and Session

Permohonan anda sedang diproses :

Your application is being processed Permohonan anda : Your application is :

Berjaya untuk tawaran bagi Semester ____________________ Sesi _____________________ :

Successful for admission in Semester _____________________ of the _______________________ Session : Tidak berjaya kerana dokumen tidak lengkap

Unsuccessful due to incomplete submission of documents Tidak berjaya

: Unsuccessful

:

Sila hubungi +603-2149 1142/1014/1113/1019 bagi mengetahui status permohonan anda. Contact the following number to know the status of your application: +603-2149 1142/1014/1113/1019.

Nama

(name)

Alamat

(Address)

Email

(E-mel)

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Lekatkan gambar

berukuran

pasport di sini

Please attach

passport-size

photograph here

BORANG PERMOHONAN BAGI

MENGIKUTI PROGRAM PENGAJIAN SISWAZAH

APPLICATION FORM FOR GRADUATE STUDIES PROGRAMME

ARAHAN KEPADA PEMOHON (INSTRUCTIONS TO APPLICANT) 1. Sila isi borang ini dalam DUA (2) salinan dan dilekatkan gambar di tiap-tiap salinan.

(Please complete this form in TWO (2) copies, and attach a photograph on each copy).

2. Pastikan semua keperluan dokumen dilampirkan bersama dengan borang permohonan ini. Semak senarai semakan sebelum menghantar borang permohonan ini. (Please ensure that all required documents are sent together with this form. Please go over the check-list before submitting this application form)

BAHAGIAN A (PART A)

1. JENIS PROGRAM : Doktor Falsafah (PhD)

(TYPE OF PROGRAMME)

Sarjana (Masters)

Diploma Pascasiswazah (Postgraduate Diploma)

Diploma Siswazah (Graduate Diploma)

Tanpa Ijazah (Non-Graduate)

2. SEMESTER DAN SESI :

(SEMESTER AND SESSION)

Maklumat : Program Pengajian Siswazah di UKM hanya mempunyai DUA (2) kali kemasukan iaitu

Semester I (Julai) dan Semester II (Disember) bagi setiap tahun.

Information : (Intakes are done twice yearly ; July for Semester I and December for Semester II.)

3. NO. KAD PENGENALAN/NO. PASPORT :

(IC NO./PASSPORT NO.)

4. NAMA :

(NAME)

5. TARIKH LAHIR :

(BIRTH DATE)

Hari (Date) Bulan (Month) Tahun (Year)

6. NEGERI & NEGARA KELAHIRAN :

(STATE & COUNTRY OF BIRTH)

7. JANTINA :

Lelaki (Male)

Perempuan (Female)

(SEX)

8 AGAMA :

(RELIGION)

9. BANGSA :

Melayu Cina India Bumiputera

(RACE) (Malay) (Chinese) (Indian) (Bumiputera)

Lain-lain (Others)

[Sila Nyatakan (Please State) ]

10. KEWARGANEGARAAN :

(NATIONALITY)

11. KAUM :

(ETHNIC)

12. TARAF PERKAHWINAN :

Bujang

Berkahwin

(MARITAL STATUS) (Single) (Married)

13. KECACATAN ANGGOTA BADAN :

(PHYSICAL DISABILITY)

Mengilham Harapan, Mencipta Masa Depan Inspiring Futures, Nurturing Possibilities

Institute of Diplomacy and Foreign Relations (IDFR)

Ministry of Foreign Affairs

Malaysia

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BAHAGIAN B (PART B) 1. JENIS PENGAJIAN : Kerja Kursus/Course Work

(TYPE OF STUDY)

Kerja Kursus dan Disertasi (Course Work and Dissertation)

Penyelidikan dan Tesis (Research and Thesis)

2. BENTUK PENDAFTARAN :

Sepenuh masa (Full-time)

(TYPE OF REGISTRATION)

Separuh masa (Part-time)

3. FAKULTI/INSTITUT/PUSAT :

(FACULTY/INSTITUTE/CENTRE) 4. JABATAN :

(DEPARTMENT)

5. PROGRAM PENGAJIAN : (PROGRAMME)

6. PENGKHUSUSAN : (SPECIALTY)

BAHAGIAN C (PART C)

1. ALAMAT SURAT-MENYURAT : (MAILING ADDRESS)

2. ALAMAT TETAP : (PERMANENT ADDRESS)

3. NO. TELEFON : (TELEPHONE)

4. TELEFON BIMBIT : (MOBILE)

5. MEL-E : (E-MAIL)

BAHAGIAN D (PART D)

1. JAWATAN SEKARANG : (PRESENT POSITION/OCCUPATION)

2. NAMA & ALAMAT MAJIKAN SEKARANG : (NAME & ADDRESS OF PRESENT EMPLOYER)

3. JAWATAN DAHULU/PENGALAMAN KERJA, jika ada [Previous Position/Work Experience, if any]

Nama Jawatan Nama Majikan Dari-Hingga Tempoh Bekerja Name of Positions (Employer(s)) (From-To) (Length of Service)

4. BANTUAN KEWANGAN : Saya dibiayai penuh oleh majikan/kerajaan negara saya (sertakan dokumen berkenaan)

(FINANCIAL SUPPORT) (I am fully sponsored by my employer/home government (please attach relevant document)

Saya seorang pelajar persendirian dibiayai oleh saya sendiri/keluarga saya

(I am self sponsored)

[Sila tandakan √ dalam petak berkenaan (Please tick √ in the appropriate box)]

Nama dan alamat penaja atau organisasi :

yang akan membayar yuran anda

(Name and address of person or organization

responsible for your fees)

(Sila sertakan DUA (2) salinan surat tajaan atau biasiswa. / Please attach TWO (2) copies of the sponsorhip or scholarship offer letter.)

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BAHAGIAN E (PART E) 1. NAMA SUAMI/ISTERI :

(NAME OF SPOUSE)

2. NEGERI & NEGARA KELAHIRAN SUAMI/ISTERI :

(SPOUSE'S STATE & COUNTRY OF BIRTH)

3. TARIKH LAHIR SUAMI/ISTERI :

(SPOUSE'S DATE OF BIRTH)

Hari (Date) Bulan (Month) Tahun (Year)

4. NO. PASPORT SUAMI/ISTERI :

(SPOUSE'S PASSPORT NO.)

5. MAKLUMAT ANAK

(INFORMATION ON CHILDREN)

Nama Anak No. Pasport Tarikh Lahir

Name of Children Passport No. Date of Birth

BAHAGIAN F (PART F) 1. KELAYAKAN PROFESIONAL

(PROFESSIONAL QUALIFICATION) Kelulusan Tahun Dianugerah Dianugerahkan oleh

(Qualification) (Year Awarded) (Awarded by)

[Sila lampirkan salinan sah sijil/surat berkenaan (Please attach certified copies of documents) ]

2. KELAYAKAN AKADEMIK (ACADEMIC QUALIFICATION)

Ijazah/Diploma Diperolehi Nama Institusi PNGK/Kelas Tahun Pengajian (Degree/Diploma) (Institution) (CGPA/Class) (Years Attended)

[Sila lampirkan salinan sah diploma, ijazah berkenaan dan transkrip] [Please attach certified copies of diploma, degree and academic transcript]

3. KELULUSAN BAHASA INGGERIS : [MARKAH/BAND] [MARKAH/BAND] [MARKAH/BAND] (ENGLISH LANGUAGE QUALIFICATION) (Mark/Band) (Mark/Band) (Mark/Band)

IELTS TOEFL Lain-lain IELTS TOEFL Others

[Please enclose TWO (2) copies of TOEFL/IELTS/Other English Language Qualification results] 4. PENERBITAN PROFESIONAL

(PROFESSIONAL PUBLICATION)

Tajuk Buku/Jurnal Tahun Diterbit Nama dan Tempat Penerbitan (Title of Book/Journal) (Year of Publication) (Name and Location of the Publication)

[Sila lampirkan salinan sah muka hadapan buku/jurnal berkenaan (Please attach certified copies of the front page the book(s) / journal(s) ]

5. KEMAHIRAN BAHASA MELAYU/BAHASA ARAB/BAHASA-BAHASA LAIN DAN KELAYAKAN SETARAF (MALAY LANGUAGE/ARABIC LANGUAGE/OTHER LANGUAGE PROFICIENCY AND EQUIVALENT QUALIFICATION)

Bahasa Nama Peperiksaan/Ujian Gred/Markah/Band Tahun Lulus (Language) (Name of Examination/Test) (Grade/Mark/Band) (Year)

Bahasa Melayu

(Malay)

Bahasa Arab

(Arabic)

[Please enclose TWO (2) copies of any other Language Qualification results]

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BAHAGIAN G (PART G) JIKA BERKENAAN (IF APPLICABLE)

1. TAJUK PENYELIDIKAN IJAZAH PERTAMA: [SARJANA MUDA] (TOPIC OF UNDERGRADUATE BACHELOR DEGREE'S RESEARCH)

2. TAJUK PENYELIDIKAN IJAZAH SARJANA :

(TOPIC OF MASTERS DEGREE'S RESEARCH)

Tesis Disertasi Projek Penyelidikan (Thesis) (Dissertation) (Research Project) [Sila tandakan √ dalam petak berkenaan (Please tick √ in the appropriate box) ]

3. LAIN-LAIN PENYELIDIKAN : Tajuk Projek Penyelidikan (Research Topic) (OTHER RESEARCH)

[Sila sertakan abstrak tesis/penyelidikan berkenaan. (Please attach the abstract of the thesis/research) ] BAHAGIAN H (PART H)

1. NAMAKAN BIDANG PENGAJIAN ATAU : PENYELIDIKAN YANG ANDA MINATI/PILIH

(STATE THE FIELD OF STUDY OR RESEARCH IN WHICH YOU ARE INTERESTED/HAVE CHOSEN)

2. NAMA CADANGAN TAJUK PENYELIDIKAN. : NAME OF PROPOSED RESEARCH.

BAHAGIAN I (PART I)

1. PERAKUAN PEMOHON (DECLARATION BY APPLICANT)

Saya akui bahawa segala maklumat dan dokumen yang saya berikan adalah benar dan lengkap. Saya akui bahawa Universiti Kebangsaan Malaysia dan Institut Diplomasi dan Hubungan Luar Negeri (IDFR), Kementerian Luar Negeri, Malaysia berhak menolak permohonan saya sekiranya maklumat serta dokumen didapati tidak benar dan tidak lengkap.

(I declare that all information and documents provided are true and complete. I acknowledge that Universiti Kebangsaan Malaysia and Institute of Diplomacy and Foreign Relations (IDFR), Ministry of Foreign Affarirs, Malaysia may reject my application if the information and documents provided are found to be false or incomplete)

Tarikh (Date) Tandatangan (Signature)

BORANG PERMOHONAN INI BERSERTA DENGAN DOKUMEN-DOKUMEN SOKONGAN HENDAKLAH DIHANTAR TERUS KEPADA: (THIS FORM, TOGETHER WITH SUPPORTING DOCUMENTS SHOULD BE SENT TO):

DIRECTOR

COMPETENCY ENHANCEMENT CENTRE INSTITUTE OF DIPLOMACY AND FOREIGN RELATIONS (IDFR)

MINISTRY OF FOREIGN AFFAIRS, MALAYSIA

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Mengilham Harapan, Mencipta Masa Depan Inspiring Futures, Nurturing Possibilities

BORANG PENJAMIN KEWANGAN (1)

(FINANCIAL GUARANTOR FORM) (1)

1. NAMA PEMOHON :

(APPLICANT'S NAME)

2. NO. PASPORT :

(PASSPORT NO.)

[Untuk Pemohon Luar Negara Sahaja (For Foreign Applicants Only) ]

[Diisi Oleh Penjamin Kewangan Sendiri (To Be Filled In By Financial Guarantor) ]

1. NAMA PENJAMIN :

(GUARANTOR'S NAME)

2. NO. KAD PENGENALAN (I/C) / :

NO. PASSPORT (PASSPORT NO.)

3. ALAMAT :

(ADDRESS)

4. NO. TELEFON PEJABAT :

(OFFICE TELEPHONE NO.)

5. NO. TELEFON RUMAH : (HOUSE TELEPHONE NO.)

6. TELEFON BIMBIT : (MOBILE)

7. PEKERJAAN : (OCCUPATION)

8. PENDAPATAN SEBULAN : (INCOME PER MONTH)

PENGAKUAN PENJAMIN (DECLARATION BY THE FINANCIAL GUARANTOR)

Saya mengaku akan menjelaskan segala bayaran pengajian pemohon di UKM sekiranya pemohon tidak mampu/gagal menjelaskannya (I hereby declare that I will settle all the outstanding payments due to UKM for the applicant for his/her study at UKM in the event that he/she is unable to do so)

Tarikh (Date) Tandatangan (Signature)

Institute of Diplomacy and Foreign Relations (IDFR)

Ministry of Foreign Affairs

Malaysia

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Institute of Diplomacy and Foreign Relations (IDFR)

Ministry of Foreign Affairs

Malaysia

BORANG PENJAMIN KEWANGAN (2)

(FINANCIAL GUARANTOR FORM) (2)

1. NAMA PEMOHON :

(APPLICANT'S NAME)

2. NO. PASPORT :

(PASSPORT NO.)

[Untuk Pemohon Luar Negara Sahaja (For Foreign Applicants Only) ]

[Diisi Oleh Penjamin Kewangan Sendiri (To Be Filled In By Financial Guarantor) ]

1. NAMA PENJAMIN :

(GUARANTOR'S NAME)

2. NO. KAD PENGENALAN (I/C) / :

NO. PASSPORT (PASSPORT NO.)

3. ALAMAT :

(ADDRESS)

4. NO. TELEFON PEJABAT :

(OFFICE TELEPHONE NO.)

5. NO. TELEFON RUMAH : (HOUSE TELEPHONE NO.)

6. TELEFON BIMBIT : (MOBILE)

7. PEKERJAAN : (OCCUPATION)

8. PENDAPATAN SEBULAN : (INCOME PER MONTH)

PENGAKUAN PENJAMIN (DECLARATION BY THE FINANCIAL GUARANTOR)

Saya mengaku akan menjelaskan segala bayaran pengajian pemohon di UKM sekiranya pemohon tidak mampu/gagal menjelaskannya (I hereby declare that I will settle all the outstanding payments due to UKM for the applicant for his/her study at UKM in the event that he/she is unable to do so)

Tarikh (Date) Tandatangan (Signature)

Mengilham Harapan, Mencipta Masa Depan Inspiring Futures, Nurturing Possibilities

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Institute of Diplomacy and Foreign Relations (IDFR)

Ministry of Foreign Affairs

Malaysia

BORANG PENYOKONG (1)

(REFEREE FORM) (1)

PERMOHONAN BAGI MENGIKUTI PROGRAM PENGAJIAN SISWAZAH

APPLICATION FOR GRADUATE STUDIES PROGRAMME Penyokong-penyokong hendaklah bukan terdiri daripada kawan atau saudara mara sendiri dan salah seorangnya hendaklah yang boleh memberikan laporan pencapaian akademik anda. The referees must not be personal acquaintances or relatives and at least one of the referees must be able to provide information/background of the applicant's academic standing. Perhatian : Borang yang tidak lengkap tidak akan diproses / (Note : Incomplete forms will not be processed)

BAHAGIAN A (PART A) Diisi oleh pemohon (To be filled in by applicant)

1. NAMA :

(NAME)

2. NO. KAD PENGENALAN/NO. PASPORT :

(IC NO./PASSPORT NO.)

3. JENIS PROGRAM :

Doktor Falsafah (PhD)

Diploma Pascasiswazah (Postgraduate Diploma)

(TYPE OF PROGRAMME)

Sarjana (Masters)

Diploma Siswazah (Graduate Diploma)

4. PROGRAM PENGAJIAN :

(STUDIES PROGRAMME)

5. FAKULTI/INSTITUT/PUSAT : (FACULTY/INSTITUTE/CENTRE)

BAHAGIAN B (PART B)

Diisi oleh Penyokong (To be filled in by Referee)

1. NAMA PENYOKONG :

(REFEREE'S NAME)

2. JAWATAN :

(OFFICIAL POSITION)

3. NAMA DAN ALAMAT MAJIKAN :

(EMPLOYER'S NAME AND ADDRESS)

4. NO. TELEFON DAN TELEFON BIMBIT :

(TELEPHONE AND MOBILE)

6. MEL-E :

(E-MAIL)

7. APAKAH PERTALIAN ANDA DENGAN PEMOHON :

(WHAT IS YOUR RELATIONSHIP WITH THE APPLICANT)

8. BERAPA LAMA ANDA KENAL DENGAN PEMOHON :

(HOW LONG HAVE YOU KNOWN THE APPLICANT)

9. TAHAP PENGAJIAN SISWAZAH YANG DISOKONG :

Doktor Falsafah (PhD)

Diploma Pascasiswazah (Postgraduate Diploma)

LEVEL OF POSTGRADUATE STUDY RECOMMENDED

Sarjana (Masters)

Diploma Siswazah (Graduate Diploma)

10. Kedudukan calon ini sebagai seorang pelajar dibandingkan dengan pelajar-pelajar lain dalam kumpulannya

(The applicant's academic status in comparison with other students in his/her group) : A) ( ) tergolong dalam 5% yang terbaik (top 5%) B) ( ) tergolong dalam 10% yang terbaik (top 10%) C) ( ) tergolong dalam 25% yang terbaik (top 25%)

D) ( ) tergolong dalam 50% yang terbaik (top 50%) E) ( ) tergolong dalam 50% yang ke bawah (bottom 50%)

11. Sila berikan penilaian anda terhadap kebolehan calon ini mengenai perkara berikut (Please rate the applicants ability in relation to the following)

ATRIBUT/ATTRIBUTES Sangat Baik Baik Sedang Lemah

(Very Good) (Good) (Fair) (Poor)

A) Kebolehan menjalankan penyelidikan bersendirian (Ability to conduct research independently)

B) Pengetahuan am (General Knowledge)

C) Kematangan dan kestabilan emosi (Maturity and Emotional Stability)

D) Motivasi (Motivation)

E) Potensi sebagai seorang 'scholar' (Potential as a scholar)

F) Kemampuan menyempurnakan sesuatu tanggungjawab (Ability to fulfill a responsibility)

Sila berikan pandangan anda terhadap pemohon ini sebagai calon pengajian siswazah. (Please describe briefly the applicant's potential for graduate study). Tarikh (Date) Tandatangan dan Cop Rasmi (Signature and Official Stamp)

Mengilham Harapan, Mencipta Masa Depan Inspiring Futures, Nurturing Possibilities

Page 10: SENARAI SEMAK PERMOHONAN (APPLICATION CHECK LIST)cas.idfr.gov.my/upload/file/application_form_master_IDFR_UKM_2016.pdf · Semak senarai semakan sebelum menghantar borang permohonan

Institute of Diplomacy and Foreign Relations (IDFR)

Ministry of Foreign Affairs

Malaysia

BORANG PENYOKONG (2)

(REFEREE FORM) (2)

PERMOHONAN BAGI MENGIKUTI PROGRAM PENGAJIAN SISWAZAH

APPLICATION FOR GRADUATE STUDIES PROGRAMME Penyokong-penyokong hendaklah bukan terdiri daripada kawan atau saudara mara sendiri dan salah seorangnya hendaklah yang boleh memberikan laporan pencapaian akademik anda. The referees must not be personal acquaintances or relatives and at least one of the referees must be able to provide information/background of the applicant's academic standing. Perhatian : Borang yang tidak lengkap tidak akan diproses / (Note : Incomplete forms will not be processed)

BAHAGIAN A (PART A) Diisi oleh pemohon (To be filled in by applicant)

1. NAMA :

(NAME)

2. NO. KAD PENGENALAN/NO. PASPORT :

(IC NO./PASSPORT NO.)

3. JENIS PROGRAM :

Doktor Falsafah (PhD)

Diploma Pascasiswazah (Postgraduate Diploma)

(TYPE OF PROGRAMME)

Sarjana (Masters)

Diploma Siswazah (Graduate Diploma)

4. PROGRAM PENGAJIAN :

(STUDIES PROGRAMME)

5. FAKULTI/INSTITUT/PUSAT : (FACULTY/INSTITUTE/CENTRE)

BAHAGIAN B (PART B)

Diisi oleh Penyokong (To be filled in by Referee)

1. NAMA PENYOKONG :

(REFEREE'S NAME)

2. JAWATAN :

(OFFICIAL POSITION)

3. NAMA DAN ALAMAT MAJIKAN :

(EMPLOYER'S NAME AND ADDRESS)

4. NO. TELEFON DAN TELEFON BIMBIT :

(TELEPHONE AND MOBILE)

6. MEL-E :

(E-MAIL)

7. APAKAH PERTALIAN ANDA DENGAN PEMOHON :

(WHAT IS YOUR RELATIONSHIP WITH THE APPLICANT)

8. BERAPA LAMA ANDA KENAL DENGAN PEMOHON :

(HOW LONG HAVE YOU KNOWN THE APPLICANT)

9. TAHAP PENGAJIAN SISWAZAH YANG DISOKONG :

Doktor Falsafah (PhD)

Diploma Pascasiswazah (Postgraduate Diploma)

LEVEL OF POSTGRADUATE STUDY RECOMMENDED

Sarjana (Masters)

Diploma Siswazah (Graduate Diploma)

10. Kedudukan calon ini sebagai seorang pelajar dibandingkan dengan pelajar-pelajar lain dalam kumpulannya (The applicant's academic status in comparison with other students in his/her group) : A) ( ) tergolong dalam 5% yang terbaik (top 5%) B) ( ) tergolong dalam 10% yang terbaik (top 10%) C) ( ) tergolong dalam 25% yang terbaik (top 25%)

D) ( ) tergolong dalam 50% yang terbaik (top 50%) E) ( ) tergolong dalam 50% yang ke bawah (bottom 50%)

11. Sila berikan penilaian anda terhadap kebolehan calon ini mengenai perkara berikut (Please rate the applicants ability in relation to the following)

ATRIBUT/ATTRIBUTES Sangat Baik Baik Sedang Lemah

(Very Good) (Good) (Fair) (Poor)

A) Kebolehan menjalankan penyelidikan bersendirian (Ability to conduct research independently)

B) Pengetahuan am (General Knowledge)

C) Kematangan dan kestabilan emosi (Maturity and Emotional Stability)

D) Motivasi (Motivation)

E) Potensi sebagai seorang 'scholar' (Potential as a scholar)

F) Kemampuan menyempurnakan sesuatu tanggungjawab (Ability to fulfill a responsibility)

Sila berikan pandangan anda terhadap pemohon ini sebagai calon pengajian siswazah. (Please describe briefly the applicant's potential for graduate study). Tarikh (Date) Tandatangan dan Cop Rasmi (Signature and Official Stamp)

Mengilham Harapan, Mencipta Masa Depan Inspiring Futures, Nurturing Possibilities