INTERNATIONAL ACTIVITIES REPORT FORM

This form is designed for faculty personnel to submit information regarding international activities happening in the faculty/ Centre of Excellence/Institute. Please fill in this form every month. If coordinator have nothing to report on a particular month, please select NO and submit. If faculty have multiple activities, please list them in the form and submit multiple attachment. This form can also be filled by the Personal in-charge of respective activities.

International Activity Form

Faculty/ Centre of Excellence/ Institute * Please SelectFaculty of Civil EngineeringFaculty of Mechanical EngineeringFaculty of Chemical & Energy EngineeringFaculty of Electrical EngineeringFaculty of Built Environment and SurveyingFaculty of ComputingFaculty of ScienceFaculty of Social Sciences and HumanitiesFaculty of ManagementRazak Faculty of Technology and InformaticsAzman Hashim International Business SchoolMalaysia-Japan International Institute of TechnologyOther Faculty/ Centre of Excellence/ Institute

Name of the PIC at Faculty (UTM Staff) *

Name of staff who report the activity

Email of the PIC at Faculty *

Email of staff who report the activity

Name of Program/Activity *

Full name of the program/activities

Type of Activity Please SelectVisit/ MeetingInternational Conference/ WebinarStudent Mobility (Inbound)Student Mobility (Outbound)Staff Mobility/ Staff Attachment/ Visiting Professor (Inbound)Staff Mobility/ Staff Attachment/ Visiting Professor (Outbound)International Research ActivitiesInternational Joint PublicationStudent RecruitmentCo-supervisorOther Type of Activity

Start Date *

Date of the program start

End Date *

Date of the program end

International Institute/ University/ Organization *

International Partner Institution/Universities/ Organization which involved in the activities (NOT including the local institution/universities)

Country of International Institute/ University/ Organization * AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongoCosta RicaCôte d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFijiFinlandFranceFrench GuianaFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorwayNorthern Mariana IslandsOmanPakistanPalauPalestinePanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbia and MontenegroSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth SudanSpainSri LankaSudanSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe

Background of Activity

Please describe about the program involves international institution/ university/ organization. Minimum Important information required are program name, international institution name, country, date of program. Please state or attach names of international visitors via this form.

Name of PIC of the Program/Activity *

Name of the PIC who responsible for the program/activities

Email of PIC of the Program/Activity *

Person in charge who responsible for the program/activities

PIC Phone Number (Mobile)

Person in charge who responsible for the program/activities

Program Website Link (if any)

Website link related to the activity (if any) i.e webpage, news etc

Attachment *

Drop a file here or click to upload Choose File

Maximum file size: 5.12MB

Please submit any attachment related to program/activities. Example : Name list, Official Letter, News etc

If you are human, leave this field blank.