PERMOHONAN PENGANJURAN SEMINAR/PERSIDANGAN/BENGKEL/FORUM/PAMERAN

DI PERINGKAT DALAMAN UNIVERSITI MALAYA, KEBANGSAAN DAN ANTARABANGSA

BAHAGIAN I - KATEGORI PERMOHONAN

Sila tandakan ()
Peringkat Antarabangsa
Peringkat Kebangsaan dan Dalaman Universiti Malaya (UM)
_____________________________________________________________________________
BAHAGIAN II - MAKLUMAT PEMOHON (PUSAT TANGGUNGJAWAB)
Nama Pegawai

Jawatan

Jabatan

PTj

_____________________________________________________________________________
BAHAGIAN III - MAKLUMAT PENGANJURAN

1.

TAJUK SEMINAR/PERSIDANGAN/BENGKEL/FORUM/PAMERAN
________________________________________________________________________
________________________________________________________________________

2.

TUJUAN
_______________________________________________________________________
_______________________________________________________________________

3.

LATAR BELAKANG
(1)

Nyatakan latar belakang seminar/persidangan/bengkel/forum/pameran

__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________

(2)

Kekerapan diadakan
__________________________________________________________________

(3)

Jawatankuasa penganjur
(Sila lampirkan)

4.

TUJUAN SEMINAR/PERSIDANGAN/BENGKEL/FORUM/PAMERAN
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________

5.

ASAS PERTIMBANGAN
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________

6.

BUTIR-BUTIR SEMINAR/PERSIDANGAN/BENGKEL/FORUM/PAMERAN
(1)

Tarikh dan Tempat

__________________________________________________________________
__________________________________________________________________

(2)

Peserta
(Sila lampirkan)

(3)

Pembentangan Kertas Kerja

(a)

Tajuk kertas kerja

____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________

(b)

Pembentang kertas kerja berserta dengan latar belakang

(Sila lampirkan)

(4)

Program (Brochure)
(Sila lampirkan)

7.

IMPLIKASI KEWANGAN
(Sila lampirkan)

8.

IMPLIKASI KESELAMATAN
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________

9.

SYOR
________________________________________________________________________
________________________________________________________________________
*Nota: Permohonan hendaklah dikemukakan selewat-lewatnya:
3 bulan sebelum tarikh penganjuran
2 minggu sebelum tarikh penganjuran

Peringkat Antarabangsa
Peringkat Kebangsaan dan Dalaman UM

BAHAGIAN IV PERAKUAN KETUA PUSAT TANGGUNGJAWAB

DIPERAKUKAN

ULASAN :

TIDAK
DIPERAKUKAN

____________________________________________________________
__________________________________________________________________

______________________________
TANDATANGAN & COP

_____________________
Tarikh

_____________________________________________________________________________
BAHAGIAN V - KELULUSAN
KELULUSAN NAIB CANSELOR/TIMBALAN NAIB CANSELOR (AKADEMIK & ANTARABANGSA):

DILULUSKAN

ULASAN :

TIDAK
DILULUSKAN

____________________________________________________________
__________________________________________________________________

______________________________
TANDATANGAN & COP

_____________________
Tarikh

Nota: Pejabat Naib Canselor/Timbalan Naib Canselor (Akademik & Antarabangsa) diminta mengemukakan
kelulusan permohonan ke Bahagian Pentadbiran Pendaftar untuk pemakluman status permohonan ke PTj
yang berkenaan.

BAHAGIAN VI UNTUK KEGUNAAN PEJABAT

Tindakan:
Untuk Diproses
Rujukan Semula

____________________________
Ketua
Bahagian Pentadbiran Pendaftar