No. Ruj.

Surat Kelulusan Cuti Belajar :

CONtrTDENTIAL P.S.D. FORM (Performance) 6/93

GOVERNMENT OF MALAYSIA

PARFORMANCE APPRAISAL ON OFFICER ATTENDING COURSE

FOR ACADEMIC YEAR/SEMESTER/QUARTER

SEcrroN I- GENEnAL NFORMATION

(To be conpleted by student)

NAME SPONSORSIIIP+:

l--l u.r-.p..'..
f--l s.L.e.e.**

[-*_.l "o*"u*o f--l orne*.

STUDET{T No.: N.RJ.C. No..*r

POSTAI ADDRESS & POSTCODEI H.S.C. No.**r

EM?LOYMENI RECORD:

Scheme of Service:

TELEPEONE No.: Grade:

Heird of Scrvice/Depanment:

COURSE DETAILS:

L Name of Institution:

2. Length of Study: 3. Date of First Rsgishation: 4. Expccled Date of

Complelion:

Pleasetick(y')
H.L.P. : Hadlah Latihan Persetutuao
SI.A.B. : Sekim Larihan Akademik Bumipulerg
N.Rl.C. : Naiional Registration ldentification Card
H,S.C. : HiEh Security Card (Kad Pengenalan Baru)
5. Degree (Po$t-gtsdu{te/Diploma/Masters/Ph.D/Others+)

6. Major/Ficld of Study:

7, Total credit hours aod/or subjecls required to com0lelc lhe progtammel

8. Totrl of tnnsfer credit houni/subjecls obtaincd from pr€Yious institution. if relevant:

9. Total credit hours/subjects accumul.rtcd to date:

10. Reserrch Dctails

(Vt be conpletul by rar/1(trch studeqt:i ottll)

(r) Thctis outlinc:......

l./) Analysis of d{l{ (slarus ro dllte): -.......

l.vhefe lot
(e) Status of research writitrg:

(i) Ch.pters drafted:

(ii) Ch.pters approved:

(iii) Chapters yet to be

a ExpecM date of subnission:

(E) Dsie of viva/defence:

 Credil Grddr

(N3.: Enclose a copy of erlminado! traosclipt)

2. GPA/Grade: 3. CGPAJCrader
RESEARCF PROGRESS
(Please use the followittg scale)

(1. Poor 3. Good 4. Very Cood 5. Excellent)

(a) Studentfs research progless accordiog to approved plan of study:

(b) Pl€ase coluDent,

STUDENT'S RATTNG
(Please use theJollowing scale)

(1, Poor 3- Good 4. Very Good Excellent)

(a) CoEmitment
(Dedicated h purruing studies) tl
(b) Integrity
(Performs tqsk with intellectual honesty) E
(c) Discipline
(Adhercs to nrles and regularions) n
(y') Wo.k quality aod efficiency
(Prbduces good work within specified time)
n
(c,) Overall p€rspective
(Abl€ to view issue6 flom a broader perspective) tl
f)

(8)
Abiliry to wo.k independertly
(Does not depend on supervisor or othsrs to perforE task)

Aucndance
tl
(Attends lectures/tutorials regularly) tt
(,,1 Languagc proficicncy (student's command of the language
of inslruction)

(i) Writtcn

(ii) Oral

Please enclose examination transcripts or detail results if it cannot be relgased to the student.

Date: Signature: ...............

Name of
Supervisor:

Department's
Oflicial Seal: