Documenti di Didattica
Documenti di Professioni
Documenti di Cultura
Application Form
Guidelines:
Name:
Email :
Fax No.:
Permanent Address:
Tel. No. :
Mobile No.:
Correspondence Address:
(if different from permanent address)
Faculty:
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05.01.2015
Page 1 of 8
Date of Study
From/ To
Date Awarded
[ ] No
Name of University :
Course :
Year Attended :
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Career Path:
Please describe your career path and what you aim to achieve in the next 5 -10 years.
Subjects that you can teach/ take tutorial session/ lab demo session:
Please list down three (3) subjects:
1.
2.
3.
Note: Kindly refer to the list of MMU undergraduate taught subjects by the relevant faculties at
http://www.mmu.edu.my
Special Needs:
Please outline any special needs and support that you may require in order to fully undertake your
studies as a consequence of any disability or medical condition.
Additional Information:
It would help with the processing of your application if you could name here any member of the
Multimedia University academic staff with whom you might already have discussed your selected
topic of research.
Referees:
Please provide names, positions and addresses of two (2) person who are able to provide references
to support your application who have knowledge of your ability to undertake the proposed study.
Referee 1
Name:
Ver.1, Rev.1
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Referee 2
Name:
Page 3 of 8
Position:
Position:
Affiliation:
Affiliation:
Correspondence Address:
Tel:
Fax:
Email:
Correspondence Address:
Tel:
Fax:
Email:
Declaration:
I hereby declare that to the best of my knowledge the above information is accurate and true, and I
give my consent for my personal information to be processed in accordance with the Personal Data
Protection Act 2010.
I have enclosed herewith:
[ ] Documentary evidence of degree/ qualification
[ ] Transcript
[ ] Evidence of English Language Proficiency
[ ] Resume
Signature:
Ver.1, Rev.1
05.01.2015
Date: ..
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CONFIDENTIAL
Referees are required to fax/ post/ email this recommendation directly to: Institute for
Postgraduate Studies, Multimedia University, Persiaran Multimedia, 63100 Cyberjaya, Selangor,
Malaysia
Tel: +603-8312 5560/ 5182 Fax: +603-8312 5300 Email: ips@mmu.edu.my
SECTION A: TO BE COMPLETED BY THE APPLICANT
Applicants Name
Identity Card/ Passport No.
Faculty
Proposed Research Topic
Tel. No.
Fax. No.
Email
SECTION B: TO BE COMPLETED BY THE REFEREE
(one of whom must be an academic referee)
Name of Referee:
Title:
Address of Organisation: ..
Phone No.: Fax No. :
Email: ..
1. Knowledge of the Applicant
Approximately how long have you known this applicant: . years
How well do you know the applicant? [Please mark (x)]
[ ] Casually
] Well
[ ] Very Well
In what capacity have you known the applicant? [Please mark (x)]
[ ] Lecturer
] Research Advisor
Ver.1, Rev.1
05.01.2015
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1 = Poor
3 = Good
5 = Outstanding
Description
Knowledge in area of proposed study
Ability to grasp new concepts
Originality and intellectual creativity
Mathematical and logical thought
Written communication skills
Teaching ability (if known)
Research ability (if known)
Perseverance toward goals
Maturity and emotional stability
Ability to work well with others
General preparation for postgraduate work
Rank
3. Recommendation: Considering this applicants academic record, special abilities, ambition, and
determination, please indicate your recommendation. [Please mark (x)]
[ ] Recommend Strongly
[ ] Recommend
[ ] Cannot Recommend
4. Additional Comments: Please add any comments which you feel will assist in evaluating the
applicants potential to pursue graduate study.
Ver.1, Rev.1
05.01.2015
Page 6 of 8
Signature:
Date: .
CONFIDENTIAL
Referee are required to fax/ post/ email this recommendation directly to: Institute for
Postgraduate Studies, Multimedia University, Persiaran Multimedia, 63100 Cyberjaya, Selangor,
Malaysia
Tel: +603-8312 5560/ 5182 Fax: +603-8312 5300 Email: ips@mmu.edu.my
SECTION A: TO BE COMPLETED BY THE APPLICANT
Applicants Name
Identity Card/ Passport No.
Faculty
Proposed Research Topic
Tel. No.
Fax. No.
Email
SECTION B: TO BE COMPLETED BY THE REFEREE
(one of whom must be an academic referee)
Name of Referee:
Title:
Address of Organisation: ..
Phone No.: Fax No. :
Email: ..
1. Knowledge of the Applicant
Approximately how long have you known this applicant: . years
How well do you know the applicant? [Please mark (x)]
[ ] Casually
] Well
[ ] Very Well
In what capacity have you known the applicant? [Please mark (x)]
[ ] Lecturer
] Research Advisor
Ver.1, Rev.1
05.01.2015
Page 7 of 8
1 = Poor
3 = Good
6 = Outstanding
Description
Knowledge in area of proposed study
Ability to grasp new concepts
Originality and intellectual creativity
Mathematical and logical thought
Written communication skills
Teaching ability (if known)
Research ability (if known)
Perseverance toward goals
Maturity and emotional stability
Ability to work well with others
General preparation for postgraduate work
Rank
3. Recommendation: Considering this applicants academic record, special abilities, ambition, and
determination, please indicate your recommendation. [Please mark (x)]
[ ] Recommend Strongly
[ ] Recommend
[ ] Cannot Recommend
4. Additional Comments: Please add any comments which you feel will assist in evaluating the
applicants potential to pursue graduate study.
Signature:
Ver.1, Rev.1
05.01.2015
Date: .
Page 8 of 8