REGISTRATION FOR NEW POSTGRADUATE STUDENTS ITEMS
PAGE
Steps for Registration – Research Mode Students
1
Steps for Registration – Coursework/Mixed Mode Students
2
Checklist for Registration
3
Medical Examination Report – For Immigration Purpose
4
Medical Examination Report – Copy for USM
9
Confirmation of Registration Form
14
Change of Address Form
15
Smart Card Application Form
16
Important Contact Details
17
INSTITUT PENGAJIAN SISWAZAH INSTITUTE OF POSTGRADUATE STUDIES STEPS FOR REGISTRATION - RESEARCH MODE STUDENTS
Start
Ensure the required document for registration as listed on Page 3 is ready
Verification of Medical Report at USM Wellness Centre (Ensure the original form is attached with photo and bring along original lab reports for verification)
YES International student?
NO
Checking of document at IPS Counter
Make payment for tuition fee at Bursary Counter
Registration confirmation and profile update at IPS Counter
Submit PASSPORT, copy of Medical Report and Student Pass fee to USM Visa Unit
Issuance of Smart Card at Smart Card Counter
Smart-card will be hold until completion of Student Pass endorsement.
YES
International student?
Copy of Student Pass need to be submitted to IPS for Smart Card collection.
NO i. ii.
Activation of official email address Visit Library to activate Smart Card usage for library services
End
1
INSTITUT PENGAJIAN SISWAZAH INSTITUTE OF POSTGRADUATE STUDIES STEPS FOR REGISTRATION - COURSEWORK MODE / MIXED MODE STUDENTS
Start
Acceptance of Offer
Registration Fee Payment
Create Email Address (Self Enrolment)
Self Upload (Smart Card)
Course Registration and Tuition Fee Payment
Verification of Medical Report at USM Wellness Centre YES (Ensure the original form is attached with photo and bring along original lab reports for verification)
International student?
NO Self Registration at IPS
Submit PASSPORT, copy of Medical Report and Student Pass fee to USM Visa Unit
YES International student?
Smart-card will be hold until completion of Student Pass endorsement. NO
Copy of Student Pass need to be submitted to IPS for Smart Card collection.
Visit Library to activate Smart Card usage for library services
End
2
Checklist for Registration
INSTITUT PENGAJIAN SISWAZAH INSTITUTE OF POSTGRADUATE STUDIES
Please (
) at the space provided.
SECTION A (Applicable for both Local and International Student).
Checklist for documents that need to be submitted during registration 1. Confirmation of registration form 2. Medical examination report, X-ray report and all lab reports (1 set of form marked For USM at top right corner) 3. Copy of payment receipt 4. Change of address form (if necessary) 5. Smart Card application form (if necessary) 6. Copy of scholarship/sponsorship letter of offer (if any) 7. Copy of latest bank statement -1 month prior to registration * applicable for International Student
SECTION B (Applicable for both Local and International Student).
Checklist for original documents that candidate needs to bring during registration 1. Original degree scrolls 2. Original academic transcripts 3. Receipt of payment 4. Scholarship/sponsorship letter of offer (if any) 5. Student pass approval letter from the Malaysian Immigration* applicable for International Student
3
For Immigration purposes (Applicable to international candidate only)
MEDICAL EXAMINATION REPORT FOR INTERNATIONAL STUDENT AND ACCOMPANYING PERSON
Affix passport size photo here (blue background)
PLEASE USE CAPITAL LETTERS
SECTION 1 (TO BE COMPLETED BY CANDIDATE) (PART A) FULL NAME (AS IN PASSPORT)
INTERNATIONAL PASSPORT NO.
NATIONALITY
DATE OF BIRTH
AGE
CONTACT NO.
D D M M Y Y ACADEMIC YEAR /
GENDER
MARITAL STATUS
MALE FEMALE
SINGLE MARRIED PROGRAMME MASTER DOCTORATE
SCHOOL / CENTRE
NEXT OF KIN (RELATIVES)
NEXT OF KIN'S ADDRESS
NEXT OF KIN'S CONTACT NUMBER
4
For Immigration purposes (Applicable to international candidate only) SECTION 1 (PART B) - Please tick ( ) in the relevant box Declaration of self and family illness. Explain in full if you or your family has any of the following illness. • Immediate family refers to father, mother, brothers / sisters
SELF
IMMEDIATE FAMILY
Yes No
Yes No
MEDICAL PROBLEMS 1. 2. 3. 3. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16.
If "Yes" please state
Congenital or inherited disorder Allergy Mental illness Fits, stroke, other neurological disease Diabetes Mellitus Hypertension Heart or vascular disease Asthma Thyroid disease Kidney disease Cancer Tuberculosis Drug addiction AIDS, HIV History of surgery Other illness
Current medication (Long term)
IMMUNISATION HISTORY (where applicable) 1. 2. 3. 4. 5.
DATE IMMUNISED
Yellow Fever BCG* Meningitis (Quadrivalent)* Hepatities B* Others
* Applicable for international candidates only.
I hereby certify that the information given above is true. I understand that my application will be rejected if there is any false information given.
Date
Signature of candidate 5
For Immigration purposes (Applicable to international candidate only)
SECTION 2 - PHYSICAL EXAMINATION To be filled by examining doctor 1. BASIC MEASUREMENT HEIGHT :
m
BLOOD PRESURE :
WEIGHT :
kg
PULSE RATE
VISION TEST : Unaided : (R) Aided
: (R)
2. GENERAL EXAMINATION ITEM a. DEFORMITIES
(L)
mmHg
:
/ min
COLOUR VISION TEST :
(L)
NORMAL / ABNORMAL
YES
NO
COMMENT
b. PALLOR c. CYANOSIS d. JAUNDICE e. OEDEMA f. SKIN DISEASES
3. SYSTEM EXAMINATION ITEM a. EYES (Including funduscopy)
NORMAL
b. EARS c. NOSE d. ORAL CAVITY / THROAT e NECK f. HEART g. LUNGS h. ABDOMEN / HERNIAL ORIFICES j.
MENTAL CONDITION
k. MUSCULOSKELETAL SYSTEM
6
ABNORMAL
COMMENT
For Immigration purposes (Applicable to international candidate only)
SECTION 3 - INVESTIGATIONS To be filled by examining doctor. URINE TEST (Please attach all the original lab report) ITEM DATE TAKEN a. ALBUMIN
RESULT
b. SUGAR c. MICROSCOPIC d. MORPHINE* e. CANNABIS* f. AMPHETAMINES TYPE STIMULANT* * Applicable for international candidates only.
BLOOD TEST (Please attach all the original lab report) ITEM DATE TAKEN a. HEPATITIS Bs ANTIGEN* b. HEPATITIS C* c. HIV* d. VDRL / TPHA* e. MALARIAL PARASITE* * Applicable for international candidates only.
CHEST X-RAY INFORMATION CHEST X-RAY NO. DATE TAKEN PLACE TAKEN
REPORT
7
RESULT
SECTION 4 - CERTIFICATION BY THE EXAMINING DOCTOR Please tick (
For Immigration purposes (Applicable to international candidate only)
) in the appropriate box
I certify that I have on this date
examined
Mr. / Ms. Passport No.
and found him / her IN GOOD HEALTH
HAVING THE FOLLOWING MEDICAL COMPLICATION(S) (Please State)
UNDERGOING TREATMENT FOR: (Please State)
Date
Signature of Doctor Name of Doctor Qualification Hospital / Clinic Registration Number Official Stamp
Remarks by University / College Official
8
Copy for USM (Applicable to local/international candidate)
MEDICAL EXAMINATION REPORT FOR LOCAL / INTERNATIONAL STUDENT AND ACCOMPANYING PERSON
Affix passport size photo here (blue background)
PLEASE USE CAPITAL LETTERS
SECTION 1 (TO BE COMPLETED BY CANDIDATE) (PART A) FULL NAME (AS IN PASSPORT / IC)
INTERNATIONAL PASSPORT NO.
I/C NO.
NATIONALITY
DATE OF BIRTH
AGE
CONTACT NO.
D D M M Y Y ACADEMIC YEAR /
GENDER
MARITAL STATUS
MALE FEMALE
SINGLE MARRIED PROGRAMME MASTER DOCTORATE
SCHOOL / CENTRE
NEXT OF KIN (RELATIVES)
NEXT OF KIN'S ADDRESS
NEXT OF KIN'S CONTACT NUMBER
9
Copy for USM (Applicable to local/international candidate)
SECTION 1 (PART B) - Please tick ( ) in the relevant box Declaration of self and family illness. Explain in full if you or your family has any of the following illness. • Immediate family refers to father, mother, brothers / sisters SELF
IMMEDIATE FAMILY
Yes No
Yes No
MEDICAL PROBLEMS 1. 2. 3. 3. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16.
If "Yes" please state
Congenital or inherited disorder Allergy Mental illness Fits, stroke, other neurological disease Diabetes Mellitus Hypertension Heart or vascular disease Asthma Thyroid disease Kidney disease Cancer Tuberculosis Drug addiction AIDS, HIV History of surgery Other illness
Current medication (Long term)
IMMUNISATION HISTORY (where applicable) 1. 2. 3. 4. 5.
DATE IMMUNISED
Yellow Fever BCG* Meningitis (Quadrivalent)* Hepatities B* Others
* Applicable for international candidates only.
I hereby certify that the information given above is true. I understand that my application will be rejected if there is any false information given.
Date
Signature of candidate 10
Copy for USM (Applicable to local/international candidate)
SECTION 2 - PHYSICAL EXAMINATION To be filled by examining doctor 1. BASIC MEASUREMENT HEIGHT :
m
BLOOD PRESURE :
WEIGHT :
kg
PULSE RATE
VISION TEST : Unaided : (R) Aided
: (R)
2. GENERAL EXAMINATION ITEM a. DEFORMITIES
(L)
mmHg
:
/ min
COLOUR VISION TEST :
(L)
NORMAL / ABNORMAL
YES
NO
COMMENT
b. PALLOR c. CYANOSIS d. JAUNDICE e. OEDEMA f. SKIN DISEASES
3. SYSTEM EXAMINATION ITEM a. EYES (Including funduscopy)
NORMAL ABNORMAL
b. EARS c. NOSE d. ORAL CAVITY / THROAT e NECK f. HEART g. LUNGS h. ABDOMEN / HERNIAL ORIFICES j.
MENTAL CONDITION
k. MUSCULOSKELETAL SYSTEM
11
COMMENT
Copy for USM (Applicable to local/international candidate)
SECTION 3 - INVESTIGATIONS To be filled by examining doctor. URINE TEST ITEM
DATE TAKEN
RESULT
a. ALBUMIN b. SUGAR c. MICROSCOPIC d. MORPHINE* e. CANNABIS* f. AMPHETAMINES TYPE STIMULANT* * Applicable for international candidates only.
BLOOD TEST (Please attach all the original lab report) ITEM DATE TAKEN a. HEPATITIS Bs ANTIGEN* b. HEPATITIS C* c. HIV* d. VDRL / TPHA* e. MALARIAL PARASITE* * Applicable for international candidates only.
CHEST X-RAY INFORMATION CHEST X-RAY NO. DATE TAKEN PLACE TAKEN
REPORT
12
RESULT
Copy for USM (Applicable to local/international candidate)
SECTION 4 - CERTIFICATION BY THE EXAMINING DOCTOR Please tick (
) in the appropriate box
I certify that I have on this date
examined
Mr. / Ms. IC / Passport No.
and found him / her :-
IN GOOD HEALTH
HAVING THE FOLLOWING MEDICAL COMPLICATION(S) (Please State)
UNDERGOING TREATMENT FOR: (Please State)
Date
Signature of Doctor Name of Doctor Qualification Hospital / Clinic Registration Number Official Stamp
Remarks by University / College Official
13
INSTITUT PENGAJIAN SISWAZAH INSTITUTE OF POSTGRADUATE STUDIES BORANG PENGESAHAN PENDAFTARAN (CONFIRMATION OF REGISTRATION FORM) NAMA PENUH / (FULL NAME):
NO. PASPORT / (PASSPORT NO.):
NO. KAD PENGENALAN / (I/C NO.):
PUSAT PENGAJIAN / PUSAT / INSTITUT (SCHOOL / CENTRE / INSTITUTE)
A. IJAZAH (DEGREE) DOKTOR FALSAFAH / KEDOKTORAN (PhD / Doctoral)
SARJANA (Masters)
B. JENIS PENCALONAN (CANDIDATURE TYPE) PENUH MASA (Full Time)
SAMBILAN (Part Time)
TIDAK BERKENAAN (Not Applicable)
Pengakuan Pelajar / (Declaration) Dengan ini saya bersetuju bahawa tesis yang dihasilkan oleh saya adalah hakcipta mutlak Universiti Sains Malaysia dan bukannya hakcipta penulis. (I agree that my thesis is the permanent property of Universiti Sains Malaysia and the copyright in its original form rests with the University and not with the author.)
Tarikh (Date): Tandatangan Calon (Signature of Candidate)
UNTUK KEGUNAAN INSTITUT PENGAJIAN SISWAZAH (For IPS Of f ice Use Only)
Tarikh Pendaftaran Pengesahan Staf IPS 14
INSTITUT PENGAJIAN SISWAZAH INSTITUTE OF POSTGRADUATE STUDIES BORANG MENUKAR ALAMAT (CHANGE OF ADDRESS) 1. NAMA (DALAM HURUF BESAR) / NAME (IN CAPITAL)
2. NO. MATRIK (MATRIC NO.)
3. NO. KAD PENGENALAN (PASSPORT NO.)
4. ALAMAT SURAT MENYURAT (CORRESPONDENCE ADDRESS)
BANDAR (STATE)
NEGARA (COUNTRY)
POSKOD (POSTCODE)
NO. TELEFON (TELEPHONE NO.)
5. BUTIR-BUTIR ALAMAT TETAP (PERMANENT ADDRESS)
BANDAR (STATE)
NEGARA (COUNTRY)
POSKOD (POSTCODE)
NO. TELEFON (TELEPHONE NO.)
Tarikh / (Date): Tandatangan (Signature) KEGUNAAN PEJABAT (FOR OFFICE USE ONLY) Tindakan oleh:
Nama & Tandatangan
15
Tarikh
INSTITUT PENGAJIAN SISWAZAH INSTITUTE OF POSTGRADUATE STUDIES BORANG PERMOHONAN KAD PINTAR (SMART CARD APPLICATION FORM) NAMA PEMOHON / (APPLICANT'S NAME): 12 huruf sahaja / (12 characters only)
NO. MATRIK / (MATRIC NO.):
Tarikh / (Date): Tandatangan Pelajar (Signature of Student) KEGUNAAN PEJABAT (FOR OFFICE USE ONLY) 1. PENDAFTARAN DIRI
LENGKAP
TIDAK LENGKAP
Tarikh Tandatangan Staf 2. PENGESAHAN SEMULA PERKARA YANG TIDAK LENGKAP
Tarikh Disahkan oleh KEGUNAAN PEJABAT (FOR OFFICE USE ONLY) 1. SESI FOTOGRAFI
BERJAYA
TIDAK BERJAYA
KOD BAR 2. KAD PINTAR DIAMBIL PADA
Tarikh Disahkan oleh
Sila bawa bersama borang ini semasa mengambil kad pintar (Please bring along this form during collection of the smart card) 16
INSTITUT PENGAJIAN SISWAZAH INSTITUTE OF POSTGRADUATE STUDIES IMPORTANT CONTACT DETAILS UNIT ADMISSION (Registration matters) (Postponement of registration date)
CONTACT NO. Main Campus +604 – 653 6027 +604 – 653 2946 +604 – 653 2937
E-MAIL
[email protected] [email protected] [email protected]
Engineering Campus +604 – 599 6528 +604 – 599 6527 +604 – 599 6525
[email protected] [email protected] [email protected]
Health Campus +609 – 767 2382 +609 – 767 2383
[email protected] [email protected]
BURSARY (Fees related matters)
+604 – 653 2995
[email protected] [email protected]
FELLOWSHIP (Financial Assistance)
+604 – 653 2983
[email protected] [email protected]
VISA (Student Pass matters)
ACCOMMODATION
Main / Engineering Campus +604 – 653 2493 +604 – 653 2774
[email protected] [email protected]
Health Campus +609 – 767 2033
[email protected]
Main Campus +604 – 653 4458 +604 – 653 4455
[email protected]
Health Campus +609 – 767 1316 +609 – 767 1302 +609 – 767 1346
[email protected] [email protected]
Engineering Campus +604 – 599 1063
17
[email protected]
INSTITUT PENGAJIAN SISWAZAH INSTITUTE OF POSTGRADUATE STUDIES SCHOOL/CENTRE/INSTITUTE PERSONNEL MAIN CAMPUS School of Housing, Building and Planning
+604–653 6193
[email protected]
School of Industrial Technology
+604–653 2218
[email protected]
Graduate School of Business (GSB)
+604–653 2795
[email protected]
School of Biological Sciences
+604–653 4035
[email protected]
School of Chemical Sciences
+604–653 3540
[email protected]
School of Communication
+604–653 3600
[email protected]
School of Computer Sciences
+604–653 3263
[email protected]
School of Distance Education
+604–653 2302
[email protected]
School of Educational Studies
+604–653 2049
[email protected]
School of Humanities
+604–653 3850
[email protected]
School of Languages, Literacies and Translation
+604–653 4543
[email protected]
School of Management
+604–653 3367
[email protected]
School of Mathematical Sciences
+604–653 2629
[email protected]
School of Pharmaceutical Sciences
+604–653 4593
[email protected]
School of Physics
+604–653 3025
[email protected]
School of Social Sciences
+604–653 3362
[email protected]
School of the Arts
+604–653 3620
[email protected]
Analytical Biochemistry Research Centre (ABrC)
+604-653 4696
[email protected]
Centre for Chemical Biology
+604-653 5513
[email protected]
Centre for Drug Research
+604-653 3274
[email protected]
Centre for Global Archaeological Research
+604-653 4148
[email protected]
Centre for Global Sustainability Studies
+604-653 2461
[email protected]
Centre for Instructional Technology and Multimedia
+604-653 3225
[email protected]
Centre for Islamic Development Management Studies
+604-653 4601
[email protected]
Centre for Marine and Coastal Studies
+604-653 2604
[email protected]
Centre for Policy Research and International Studies
+604-653 3385
[email protected]
Institute of Nano Optoelectronics Research and Technology (INOR)
+604-653 5646
[email protected]
National Advanced IPV6 Centre
+604-653 3001
[email protected]
National Higher Education Research Institute
+604-653 5754
[email protected]
National Poison Centre
+604-653 2078
[email protected]
Women’s Development Research Centre
+604-653 3433
[email protected]
HEALTH & BERTAM CAMPUS Advanced Medical & Dental Institute
+604-562 2352
[email protected]
Center for Neuroscience Services and Research
+609-767 2357
[email protected]
Institute for Research in Molecular Medicine
+604-653 4807
[email protected]
School of Dental Sciences
+609-767 5522
[email protected]
School of Health Sciences
+604-767 7522
[email protected]
School of Medical Sciences
+604-767 6052
[email protected]
18
INSTITUT PENGAJIAN SISWAZAH INSTITUTE OF POSTGRADUATE STUDIES ENGINEERING CAMPUS River Engineering & Urban Drainage Research Centre
+604-599 5464
[email protected]
School of Aerospace Engineering
+604-599 5967
[email protected]
School of Chemical Engineering
+604-599 5880
[email protected]
School of Civil Engineering
+604-599 6209
[email protected]
School of Electrical and Electronic Engineering
+604-599 6011
[email protected]
School of Materials and Mineral Resources Engineering
+604-599 6168
[email protected]
School of Mechanical Engineering
+604-599 6305
[email protected]
19
Version: March 2017 Institute of Postgraduate Studies Universiti Sains Malaysia 11800 USM Penang, MALAYSIA. email :
[email protected] www.ips.usm.my
