REVISION NO.

: IRKHS/2
LAST REVISED : SEPT 2005

KULLIYYAH OF ISLAMIC REVEALED KNOWLEDGE AND HUMAN SCIENCES

ADJUSTMENT FORM
(TO BE USED DURING ADJUSTMENT PERIOD ONLY)
SECTION A (PERSONAL INFORMATION - TO BE FILLED IN BY THE STUDENT)

NAME : ____________________________________________________________ TELEPHONE NO. :________________________

MATRIC NO. : _________________________________________ EMAIL ADDRESS : ________________________

MAJOR / PROGRAMME : _________________________________________ DATE OF APPLICATION : ________________________

SESSION : _______________________ SEMESTER :___ SIGNATURE : ________________________

CGPA : _________________________

SECTION B (REGISTRATION INFORMATION - TO BE FILLED IN BY THE STUDENT)

TICK (/) IN THE RELEVANT BOX :

1.SECTION CLOSED 2.STUDY PLAN PROBLEM

(PLEASE STATE THE ERROR)
*Please provide a copy of your study plan.
3.OTHER PROBLEM
(E.G: LATE REGISTRATION, UNDERLOAD,
SUBJECT CLASH, REPEATING FAILED SUBJECT)
*Please attach any relevant document to support your application.

REASON / ERROR / PROBLEM :

I WOULD LIKE TO REGISTER THE FOLLOWING COURSE : (ONE FORM FOR ONE COURSE ONLY)

COURSE CODE COURSE TITLE SECTION CREDIT HOURS

CURRENT WORKLOAD (CREDIT HOURS) : ______________

SECTION C (RECOMMENDATION - TO BE FILLED IN BY THE KULLIYYAH)

** PLEASE REFER NOTES BELOW.

COMMENT / REMARK :

____________________________________________________________________ SIGNATURE & STAMP : ________________________

____________________________________________________________________ DATE : ________________________

COMMENT / REMARK :

____________________________________________________________________ SIGNATURE & STAMP : ________________________

____________________________________________________________________ DATE : ________________________

NOTES :
KULLIYYAH SUBJECT : RECOMMENDATION FROM SUBJECT’S LECTURER & HEAD OF DEPARTMENT.
CELPAD SUBJECT : RECOMMENDATION FROM SUBJECT’S COORDINATOR ONLY.

SECTION D: FOR OFFICE USE

ACTION :

____________________________________________________________________ SIGNATURE & STAMP : _________________________

____________________________________________________________________ DATE : _________________________