C.

Soal Selidik
Questionnaires
1. Penglibatan dalam aktiviti Kokurikulum / Jawatan / Involvement in Cocuriculum
Activities / Position in Club
i) ..................................................................................................................................
.................................
ii) .................................................................................................................................
.................................. [ SEKRETARIAT CHEST 15/16 ]
iii) ................................................................................................................................
APPLICATION FORM
PASTE YOUR
...................................
PICTURE
SEKRETARIAT CHEST 15/16
HERE
(Bulatkan jawapan yang dipilih)
UNIVERSITI MALAYSIA PAHANG
( Circle the answer that you have selected )
1. Maklumat
Saya mempunyai
menjadi
sekretariat
sebelum
ini. ( YA /
A.
Peribadipengalaman
Pemohon ( Sila
Gunakan
HURUFCHEST
BESAR
)
TIDAK )
Applicant Information ( Please Use CAPITAL LETTER )
I have the experience became as previous CHEST secretariat ( YES / NO )
Nama Penuh /
Jika ''YA''
, sila nyatakan anda sekretariat dibawah exco
Fullname
: ....................................................................................................................
mana : ...............................................................
..........
''YES''
, please state
you
under what
No.IfKad
Pengenalan
/ IC No.
: .............................................................
exco.........................................
: ............................................................................................
No.:

ID

2. Saya Rumah
taat mengerjakan
amalan dalam agama saya anuti. ( YA / TIDAK )
Alamat
/ Home
Adress : .....................................................................................................................
I do practice the religion that I belong obediently. ( YES / NO )
.....................................................................................................................................
3. Saya sentiasa memelihara imej dan sahsiah saya sebagai seorang pelajar UMP
...................................
sama ada dalam atau
Poskod / Postcode : ....................... Bandar/ City : .............................
Negeri/
luar kampus ( YA / TIDAK )
State : ............................
I always keep my image and personality as a UMP student either in or outside
Jantina / Gender ( Male/Female ) : ....................................
Agama /
campus. ( YES / NO )
Religion : .........................................
4. Saya berminat untuk hadir ke setiap program CHEST yang dianjurkan ( YA / TIDAK
B. Maklumat Akademik Pemohon (Sila Gunakan HURUF BESAR )
)
Applicant Academic Information ( Please Use CAPITAL LETTER )
I am very interested in attending the CHEST proggrammes ( YES / NO )
Kursus Pengajian /
5. Jika diberi pilihan, sekretariat pelaksana manakah yang menjadi 3 pilihan utama
Course : .......................................................................................................................
anda?
....
If given a choice, which is the secretariat which suits you most three (3) ?
Tahun Pengajian / Years of Study ( 1 / 2 / 3 / 4 ) : ................... PNGK Terkini / Latest
CGPA : ......................
. KERJAYA, INDUSTRI DAN ALUMNI / CAREER, INDUSTRY AND ALUMNI
Nama Penasihat Akademik / Name of Academic
. DAYA SAING
AKADEMIK DAN INOVASI / COMPETITIVENESS OF ACADEMIC AND
Advisor
: ...........................................................................
INNOVATION
. KHIDMAT MASYARAKAT, SUKAN DAN REKREASI / EXTERNAL RELATIONS, SPORTS AND
RECREATION