Research Internship/Attachment Application Form

Before proceeding please ensure you have these document ready as attachment in PDF/JPG.

Passport size photos (white background)
A recommendation Letter from student`s Academic Advisor/home institution supporting their application
A status letter from student’s home institution with this FORMAT OF STATUS LETTER.
If the student is sponsored, state the details of sponsorship such as the name of sponsor, duration of sponsorship and value of sponsorship
An up-to date certified academic transcript (in English translation)

*Please submit application 3 month before the program starts

A. Applicant/Participant Personal Details

Full Name (same as passport) *

Citizenship *

Gender *

Mailing Address Line 1 *

Address Line 2 *

City *

ZIP/ Postal Code *

Country *

Date of Birth *

Mobile Phone Number *

International format

Email *

Status *

Married

Single

Religion *

Passport Number

B. Education Background

Home Institution/University *

Website

Paste URL here.

Home Faculty *

Programme Name *

Chemical Engineering, English, Business, Chemistry, Psychology etc.

Level of Study *

Undergraduate

Master

Doctorate

OtherOther

If other, please state.

Nature of Study *

Taught Course

Taught Course & Research

Research

C. Study Abroad Programmes

Status *

Proposed Courses to be taken in UTM

Subject/Course

Code

Credit

Add Remove

Course/Subject Selection

Subject: Introduction to Biomedical Eng
Code : SMBE1012
Credit : 2

Please click the + button to add more subjects/courses

Please only choose courses corresponding to the semester. If you are studying in UTM in Semester 2, please choose only courses available in semester 2,4,6 and 8.

Proposed Start Date *

Proposed End Date *

English Speaking Proficiency *

Very Good

Good

Poor

Very poor

English Reading Proficiency *

Very Good

Good

Poor

Very poor

English Writing Proficiency *

Very Good

Good

Poor

Very poor

Host Faculty

Supervisor Name *

Please specify name of host supervisor (if available)

Research Project

Specify research project if applicable

Transfer of Credit required? *

Yes

D. Finance

Sponsorship *

Self-sponsored

Home Institution

OtherOther

E. On-Campus Accomodation

Please be informed that we can provide on-campus accommodation upon request and is SUBJECT TO AVAILABILITY. Please choose room type for booking. Range for rate for single room : RM20/day/person to RM50/day/person. Room rate may vary depending on residential college. The basic room type is single/ twin room, ceiling fan, share bathroom with the room rate RM20/ day

Interested to stay with Host Family in Malaysia?

Yes

More information about host families is available at https://international.utm.my/keluargaangkat

F. Inter-office Communication

Please provide the contact details of the person from your university who is responsible to assist you in this program ( international affairs officer/student exchange coordinator).

Name of Officer in charge (International Office) *

Office/Department *

International Office of Your University Address Line 1 *

Address Line 2

City *

ZIP / Postal Code *

Phone number *

International format

Email (International office) *

G. Attachment and Declaration

Recommendation Letter *

Maximum upload size: 5.12MB

Recommendation letter from student's Academic Advisor/Home Institution supporting their application

Student Status Letter *

Maximum upload size: 5.12MB

Letter from Home University that state's the student has student status and covers the following details: current semester, active/inactive and expected graduation year.

Academic Transcript *

Maximum upload size: 5.12MB

An up-to-date certified academic transcript (translated to English)

Passport Photo *

Maximum upload size: 5.12MB

Passport-sized photos (white background only) in jpg. format

Sponsorship Document (if applicable)

Maximum upload size: 5.12MB

Research Proposal

Maximum upload size: 5.12MB

Please attach your research proposal (Master and PhD)

Study Plan Essay *

Maximum upload size: 5.12MB

A one page essay to describe your plans and expectations for this program.

Once the application has been approved, UTM International will issue an offer letter for the program. You will need to provide a copy of your passport and travel/medical insurance certificate.

For students coming for more than six (6) months, you will need to provide a copy of your medical report.

Checkboxes *

I hereby declare that the information provided in this form is true. I acknowledge that Universiti Teknologi Malaysia reserves the right to vary or reserve any decision regarding admission or enrolment made on the basis of the given information.