Borang PTAR(BPP)/Data/01/2005/pind.

2013

PERPUSTAKAAN TUN ABDUL RAZAK, UiTM SHAH ALAM

BORANG DATA PELANGGAN/ LIBRARY MEMBERSHIP FORM
(Sila isi dengan HURUF BESAR/ Please complete in block capitals)
TARIKH / DATE

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NO. PELAJAR/STAF

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STUDENT/STAFF NUMBER

NO. K/P (I/C)

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ID NO / PASSPORT NUMBER

NAMA / NAME

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E-MEL/ E-MAIL

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ALAMAT RUMAH (TETAP)

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PERMANENT ADDRESS

--------------------------------------------------------------------------------------------------------------------FAKULTI /PUSAT/UNIT

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FACULTY / UNIT

KOD PROGRAM/KURSUS

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PROGRAMME CODE

NO. TEL. RUMAH/ TELEPHONE (HOUSE)

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NO. TEL. PEJABAT/ TELEPHONE (OFFICE)

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NO. TEL. BIMBIT/ MOBILE PHONE

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TARIKH MASUK UiTM/ DATE ENROLLED

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TARIKH TAMAT/ EXPIRY DATE

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KATEGORI PEMINJAM/ PATRON CATEGORY : --------------------------------------------------------(Sila lihat di belakang borang/ Please refer at the back of the form)
Saya mengaku maklumat yang diberikan di atas adalah benar dan saya juga bersetuju mematuhi semua peraturan
perpustakaan yang ditetapkan / I hereby acknowledge that all information provided herein is true and agree to abide to
the library rules and regulations.
Tandatangan Pemohon :
Applicants Signature :

Untuk Kegunaan pejabat / For Office Use Only

Lokasi Perpustakaan / Location

:______________

Pegawai Bertugas / Person in Charge

Dikemaskini pada Oktober 2013

: ______________

Tarikh / Date

KATEGORI/CATEGORY

KOD

Jurulatih sepenuh masa/ Full time trainers

Jurulatih sementara / Temporary trainers
Jurulatih kontrak /Contract trainers
Jurulatih sambilan / Part-time trainers

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:
:
:

JA
JB
JC
JD

Kakitangan akademik / Academic staff

Kakitangan akademik sementara/ Temporary academic staff
Kakitangan akademik kontrak / Contract non academic staff
Kakitangan akademik sambilan / Part-time non academic staff

:
:
:
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KA
KB
KC
KD

Kakitangan bukan akademik / Non academic staff

Kakitangan bukan akademik sementara /Temporary non academic staff
Kakitangan bukan akademik kontrak/ Contract non academic staff
Kakitangan bukan akademik sambilan / Part-time non academic staff
Kakitangan bukan akademik harian / Daily non academic staff

:
:
:
:
:

KP
KQ
KR
KS
KT

PELAJAR SEPENUH MASA / FULL TIME STUDENT

Sijil / Certificate
Matrikulasi / Matriculation
Pra sarjana/ Pre master
Diploma/ Diploma
Diploma lanjutan/ Advanced Diploma
Ijazah / Degree
Profesional /Profesional
Program antarabangsa / International program
Sarjana /Master
PHD/PHD

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:
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S01
S02
S03
S04
S05
S06
S07
S08
S09
S10

PELAJAR SEPARUH MASA / PART TIME STUDENT

Program antarabangsa / International program
Sarjana / Master
PHD/PHD

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:
:

SP1
SP2
SP3

PELAJAR PENGAJIAN LUAR KAMPUS/OFF CAMPUS STUDY

Diploma / Diploma
Diploma lanjutan / Advanced Diploma
Ijazah /Degree
Professional /Profesional

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LK1
LK2
LK3
LK4

PROGRAM PEMBELAJARAN FLEKSIBLE / FLEKSIBLE LEARNING PROGRAM

Sijil / Certificate
Diploma/ Diploma
Ijazah / Degree
Sarjana /Master

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:
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:

PF1
PF2
PF3
PF4

SEPENUH MASA LEBIH TEMPOH/EXTEND FULL TIME STUDENT

Diploma/ Diploma
Diploma lanjutan/ Advanced Diploma
Ijazah / Degree
Sarjana /Master

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:
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:

SL1
SL2
SL3
SL4

SETARA SEPENUH MASA/FULL TIME EQUIVALENT

Ijazah /Degree

SS

Program antarabangsa/Student exchange

EXC

Kakitangan perpustakaan/Library staff

Pelanggan luar / External users

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:

SF
AL

Dikemaskini pada Oktober 2013