UPSI/IPS-1-BO 14
Pind. : 01 m/s 1/2
Institut Pengajian Siswazah / Institute of Graduate
Studies
RAYUAN MENERUSKAN PENGAJIAN
Borang permohonan ini perlu dihantar kepada APPEAL
pihak IPS dalamFOR RE-ENROLLMENT
tempoh tiga (3) minggu daripada tarikh surat
pemberitahuan pemberhentian atau selepas kelulusan mesyuarat Senat.
Pelajar perlu melampirkan draf tesis/disertasi/kertas projek bersama borang permohonan (jika berkaitan).
Pelajar juga perlu membayar wang proses sebanyak RM25.00 dan Kos Pentadbiran sebanyak RM300.00 semasa
mengemukakan permohonan melalui e-payment. (sila lampirkan resit pembayaran)
Permohonan yang lengkap sahaja yang akan diproses dan dibawa masuk ke Mesyuarat Jawatankuasa Pengajian Siswazah
(JPS).
Kelulusan hanya akan diperoleh dalam tempoh tiga (3) hari bekerja setelah JPS dijalankan.
This form must be submitted to IGS within three (3) weeks of the date of termination letter after Senate meeting approval.
Please attach your draft of thesis/dissertation/project paper (if applicable).
Students also need to pay RM25.00 processing fees and Administrative Cost of RM300.00 when submitting the application through e-
payment. (Please attach the receipt).
Only completed application will be processed and brought to Graduate Studies Committee Meeting. The approval can be
obtained within three (3) working days after the meeting is conducted.
Bahagian I / Section I : MAKLUMAT PELAJAR / STUDENT’S DETAILS
Nama / Name
No.Matrik / Matric No.
Bidang / Field of Study
Mod Pengajian/ Mode of Study
Semester/ Semester
Fakulti / Faculty
Adakah anda pernah membuat
permohonan meneruskan pengajian
sebelum ini? Ya / Yes Tidak / No
Have you applied for re-enrollment previously?
Jika ‘YA’, sila nyatakan bila permohonan
dilakukan.
If ‘YES’, please state the application was made
Justifikasi rayuan dilakukan (sila
lampirkan dokumen sokongan jika
ruangan tidak mencukupi).
Justification for appeal (please attach
supporting documents if the space is limited).
Tandatangan Pelajar / Student’s Signature Tarikh / Date
UPSI/IPS-1-BO 14
Pind. : 01 m/s 2/2
Bahagian II / Section II : KEGUNAAN PUSAT ANTARABANGSA DAN MOBILITI / INTERNATIONAL & MOBILITY
CENTRE (IMC) OFFICE USE (**untuk pelajar antarabangsa sahaja/For international student’s only)
(UNTUK DIISI OLEH PENGARAH / TIMBALAN PENGARAH SAHAJA/TO BE FILLED BY THE DIRECTOR / DEPUTY DIRECTOR ONLY)
Ulasan IMC / IMC’s Review
Tarikh / Date
Tandatangan & Cap / Signature &
Stam
Bahagian III / Section III : PENGESAHAN PENYELIA DAN FAKULTI / SUPERVISOR AND FACULTY ENDORSEMENT
1. PENYELIA/ SUPERVISOR 2. FAKULTI/ FACULTY
Nama Penyelia/Supervisor Name: ……………………………. Sokongan Dekan/Timbalan Dekan Fakulti:
Recommendation of Dean/Deputy Dean:
..................................................................
Peratusan tesis telah siap/Percentage of completed thesis: Diluluskan/ Approved
Tidak Diluluskan / Not Approved
Sokongan/Supported:
Ya/Yes
Tidak/No
Ulasan Penyelia/Supervisor Review : Ulasan Fakulti/Faculty Review :
……………………………………………………........................... ……………………………………………………...............................
………….………….………….………….……….......................... ………….………….………….………….………..............................
.……………………………………………………………………… ..............................................................................................
........
………………………….........................
Tandatangan & Cap / Signature & Stamp ……………………………..
Tandatangan & Cap / Signature & Stamp
…………………………
Tarikh/ Date …………………………
Tarikh/ Date
Bahagian IV / Section IV : KEGUNAAN IPS / IGS USE
Tandatangan & Cap / :Signature & Stamp
Ulasan/Comment Tarikh / Date
Perhatian : Permohonan yang lengkap sahaja yang akan diproses dan dibawa masuk ke Mesyuarat Jawatankuasa Pengajian Siswazah (JPS). Kelulusan hanya
akan diperoleh dalam tempoh tiga (3) hari bekerja setelah Mesyuarat JPS dijalankan.
Note : Only completed document will be processed and brought to Graduate Studies Committee Meeting. Approval can be obtained within three (3) working days after
the meeting.
