APPLICATION FORM

USM FELLOWSHIP SCHEME

APPLICATION REQUIREMENTS/INSTRUCTIONS

1.

Full time registered graduate student of Universiti Sains Malaysia.

2. Undertaking Masters/PhD programme by Research Mode

3. CGPA of not less than 3.00 at Bachelors level or equivalent qualification recognized by
the Malaysian government or a good Masters Degree.
4. Not a recipient of any scholarship/ financial aid.
5. The completed application should consists of the following documents :
- A copy of your CV
- Detailed research proposal containing research programme and time required for
research
(a)
Background literature
(b)
Objectives
(c)
Research methodology
(d)
Expected outcomes
(e)
Gantt chart
6.

Completed forms must be endorsed by Supervisor and Dean.

7.

Submit completed application form to:

Dean
Institute of Graduate Studies
Universiti Sains Malaysia
11800 Minden, Penang
Malaysia

A.

APPLICANTS PARTICULARS

1.

Name (Please print/type):

2.

I/C / Passport No.:

3. Address:

4.

E-mail:

5. Registration Date:

6.

Telephone No. (Handphone) :

(Lab) :

7.

Matric No:

8. School/Centre:

9.

Degree:

10. Research Area:

(if applicable)

11. Research Title:

12. Main Supervisor:

13. Co-Supervisor:

(if applicable
B. ACADEMIC BACKGROUND
(Kindly attach certified copies of all academic transcripts)

Bachelors Degree
1.

Masters Degree

University

2. Duration

From:

From:

To:

To:

3. Programme Mode
4. Area
5. CGPA/Class
C. SCHOLARSHIPS (if applicable)
1.

Sponsor

2.

Type

3.

Amount

4.

Duration

Scholarship/Loan

Scholarship/Loan

From:

From:

To:

To:

D. RESEARCH EXPERIENCE

(If applicable; please provide evidence)

1.

2.

3.

USM Fellowship Scheme

E.

PUBLICATIONS

(If applicable; please provide copies)

1.

2.

3.

F. DECLARATION
1.
2.

I declare that I am not a recipient of any scholarship or financial aid.

I certify that all the information given in this application is complete and correct to
the best of my knowledge

Signature

Name

Date

: .

G. DEANS ENDORSEMENT

.
.
.

Signature

: .
(

Official Stamp :

Date

: ..

USM Fellowship Scheme

H. FOR OFFICE USE ONLY

i. Dean of Institute of Graduate Studies Endorsement

..

Date: .

Signature: .

ii. The Committee of the USM Fellowship recommended the following decision on
.

Results

Comments

Accept

KIV

Reject

USM Fellowship Scheme

1.

SUPERVISORS REPORT
(Confidential report - to be filled by Main Supervisor)
Name:-

2.

School/Centre:-

3.

Candidates Name:-

4.

Candidates Research Area:-

5.

Research Programme Related to Candidates Research:-

6. Please State:a. Candidates involvement and ability to conduct research:

.

..
b. Potentials of the research area:

..
c.

Supervisors Endorsement:

..
..
Signature

:.
(
)

Official Stamp :
Date

This is confidential report. Please mail directly to :

Dean
Institute of Graduate Studies
Universiti Sains Malaysia
11800 Minden
USM Fellowship Scheme

Penang, Malaysia

USM Fellowship Scheme