UiTMJB/HEA/UR/2008-6

BAHAGIAN HAL EHWAL AKADEMIK

UiTM KAMPUS BANDARAYA JOHOR BAHRU

BORANG PERMOHONAN PERTUKARAN KAMPUS

1.

2.

MAKLUMAT PELAJAR
Nama Pelajar

__________________________________________________

No. Kad Pelajar UiTM

______________________No.K/P: _____________________

Program

______________________No Tel: _____________________

Bahagian

______________________Semester: ___________________

ALASAN PERMOHONAN DIKEMUKAKAN ( Sila sertakan dokumen sokongan) :_______________________________________________________________________________

_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________

3.

Tandatangan Pelajar

______________________________________

Tarikh permohonan

______________________________________

ULASAN KOORDINATOR PROGRAM / KAUNSELOR:_______________________________________________________________________________

_______________________________________________________________________________
_______________________________________________________________________________

4.

Tandatangan & Cop

_____________________________________

Tarikh

_________________________________________

KELULUSAN KOORDINATOR KAMPUS:

* SOKONG/TIDAK DISOKONG

Tandatangan & Cop

___________________________________________

Tarikh

___________________________________________

PERINGATAN PENTING:
Pelajar tidak dibenarkan meninggalkan kuliah sehingga surat kelulusan rasmi dari
Koordinator UiTM Kampus Bandaraya Johor Bahru dikeluarkan.