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UniKL/AAD/PEX05-F01

VERIFICATION OF STUDY COMPLETION STATUS

A. STUDENT'S PROFILE (To be filled by the final semester student)

Important. Please take note that :


1. You are required to complete this form once you have fulfilled the academic requirements for graduation.
2. Student with financial outstanding will not be allowed to attend the convocation event and academic certificate and transcripts will not be released until the
outstanding amount is paid.
3. Print your study plan from the Student's Online Services and get verification from the Programme Coordinator
4. Attach the Study Plan and a copy of identification card with this form.
5. If you are unable to graduate on the expected date indicated below, you must submit a new application.
Expected Date of Completion (Please tick)

May December Short Semester Year ____________

STUDENT NAME :

(As in IC / Passport)

IC NUMBER : STUDENT NUMBER :

PROGRAMME :

MAILING ADDRESS (All mails including will be directed to this address)

HP NO. EMAIL :

Please state the status of the following subjects :


Credit Semester Taken
Exempted Grade Obtained
(please tick)
(If not exempted)

MPW1113 / MPW2113 (B. Kebangsaan)


MPW1133 / MPW2133 (Peng. Malaysia)
MPW1143 / MPW2143 (Peng. Islam)
MPW1153 / MPW2153 (Peng. Moral)
WCD10101 Co-Curriculum 1
WCD10201 Co-Curriculum 2

WID39904 / WIB39906 / Intra (if applicable)

Please state the subject codes taken this semester :

Credits Taken This Semester Total Credits Expected To Gain

Total Credits Gained for the previous Semester


Total Approved Credit Transfer
Total Credits Offered as per Study Plan
CGPA (Previous Semester*)
* To graduate, CGPA ≥ 2.0
I confirm the above information is true and acknowlege that I do not have any outstanding subjects.

Student's Signature __________________________ Date : _________________

Please return this form the latest by 25 October 2010 to :


Contact Numbers of the Academic Affairs Division (City Campus) and Academic Affairs Department (Institute)
INSTITUTES TEL NO FAX NO Attention
City campus ( MIIT & IPROM) 03-21754000 03-21754446 Pn.Rehanna Mansor/ Pn. Noor Saleha Ghazali
UniKL MFI 03-89262022/ 03-89262618 03-89258845 Pn Maziana Zaini/Nina Munif/
UniKL BMI 03-61841000 03-61864040 Pn.Jasmin Ahmad
UniKL MIAT 03-87688487 03-87688485 En. Jaldin Ahmad/Pn Azlina Ali
UniKL MSI 04-4035200 04-4035201 Pn.Norliza Amran
UniKL MIMET 05-6909000 05-6909092 En.Zaimi Zainal Mukhtar/Cik Rahazan Daud
UniKL RCMP 05-2432635 05-2432636 Pn. Nurul Khairana Azudin
UniKL MICET 06-5512000 06-5512001 Pn.Norain Kamaruddin

OFFICE USE ONLY

B. PROGRAMME STRUCTURE COMPLETION


(To be filled by the Programme Coordinator)

STUDENT NAME :

STUDENT NUMBER :

Total credits to graduate for this programme :

Achieve Minimum Credits to Graduate? Yes No

**Complete all required subjects stated in the programme structure? Yes No


(**Please sign as verification on the study plan)

I confirm that the above information is correct and the student is eligible to graduate.

Signature __________________________ Date : _________________________

Name & Position

C. RECORDS VERIFICATION
(To be filled by Academic Affairs)

All information is properly filled and the final CGPA is ≥ 2.00 Yes No

The name is included in the Completed List for Senate's approval Yes No

Signature __________________________ Date : _________________________

Name & Position

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