UTM Razak Postgraduate workstation Application UTM Razak Faculty Postgraduate workstation Application If you are human, leave this field blank. Student personal Information Full Name: * Current / Active Address: * Matrix Card Number: * IC/Passport No: * Mobile Phone Number: * Email Address: * Name of Main Supervisor: * Supervisor Email Address: * Research Title : * Program: * Semester: * Date of first registration: * month/date/year Date of expected completion : * Enrollment : * Package 1 (Weekdays) Package 2 (Weekend) Mode: * Full Research Coursework Mix-Mode Category: * Local Students International Students Visa Expiry Date: * I agree that i will use the facilities appropriately and will take full responsibility towards sanitation, equipment's and safety during the period of use of the workspace. I also agree to adhere to the rules stated. In additon, i assume full responsibility and any action taken against me for the loss and damage caused resulting from my negligence. i also acknowledge that i am expected to be at my workstation regularly, as non-regular usage may result in the facility being revoked. Herewith enclosed is a deposit of RM 50.00 (Ringgit Malaysia: Fifty Ringgit Only). The deposit will be refunded upon expiry of the period of occupancy. Click for the term and condition * I Agree Submit
