UTM Student Academic Visit Online Application Form Application for Student Academic Visit to UTM A. Visit Details Application must be made 14 days prior to the visit date Proposed End Date * Proposed Start Date * Time 91011121234 : 0030 AMPM Range meeting time is between 9:00 - 16:00. University/ Institute/ Organization Name * Country Name of officer in charge (International Office) * This should be the contact from the International Office in your university. International Office Contact Number International Office Email Address * B : Contact Person Group Leader Name * Group Leader Contact Number * Group Leader Email Address * C. Program Background / Objectives This form can be filled up as a group. Host Faculty/ Department at UTM Please ChooseFaculty of Civil Engineering - UTM Johor BahruFaculty of Mechanical Engineering - UTM Johor BahruFaculty of Chemical & Energy Engineering - UTM Johor BahruFaculty of Electrical Engineering - UTM Johor BahruFaculty of Built Environment and Surveying (FABU) - UTM Johor BahruFaculty of Computing - UTM Johor BahruFaculty of Science (FS) - UTM Johor BahruFaculty of Social Sciences and Humanities (FSSH) - UTM Johor BahruFaculty of Management - UTM Johor BahruRazak Faculty of Technology and Informatics - UTM Kuala LumpurAzman Hashim International Business School (AHIBS) - UTM Kuala LumpurMalaysia-Japan International Institute of Technology (MJIIT) - UTM Kuala LumpurUTM International (International Office)Other Host Faculty/ Department at UTM Program Background * Objective of the visit * D. Group Category Group Category Please SelectA group of student onlyA group of student and staff Participant(s) List including Group Leader (All participant names must be listed) Name * Position/Year/Course * Passport Num. * Gender * Staff/ Student Email * Add Remove If you are human, leave this field blank.