UteM FTMK 6 NOV 2013

UNIVERSITI TEKNIKAL MALAYSIA MELAKA

FAKULTI TEKNOLOGI MAKLUMAT DAN KOMUNIKASI

SUBMISSION OF THESIS PRELIMINARY REPORT

Section A: (To Be Completed By Candidate)
(Please tick ( ) in relevant boxes)

Dean
Fakulti Teknologi Maklumat dan Komunikasi,
Universiti Teknikal Malaysia Melaka,
Hang Tuah Jaya,
76100 Durian Tunggal
Melaka.

Submission of Thesis Preliminary Report

Siti Nur Azrreen Binti Ruslan

I, .......................................................................................................................................... , a candidate for
Full Time Part Time Master PhD in the field of ................................................
........................................................................................................................... is submitting three (3)
copies of thesis preliminary report for oral examination. The title of thesis is given as follows:-

Title :
..........................................................................................................................................................
........................................................................................................................................................

My personal particulars are as follows:-

Siti Nur Azrreen Binti Ruslan

Name : ........................................................................................................................................................
99, Hala Tasek Timur 11, Kampung Tersusun Tasek, Ipoh, Perak
Address: ....................................................................................................................................................
................................................................... 31400
Postcode :.............................................................
M031220054
Matrix No. : ....................................................... Office : ................................................................
Telephone (Home) :................................................. 013-6895685
H/Phone : ..............................................................
nurazrreen@hotmail.com
E-mail : .................................................................... Fax : ....................................................................

Thank you.

.......................................... ....................
(Signature of candidate) (Date)

For office use

Acknowledgement of Receipt :
Name of Staff : ......................................... Date : .................................

1
 VERIFICATION BY MAIN SUPERVISOR

Section B: (To be completed by Main Supervisor)

Dr. I Gede Pramudya Ananta

I, ......................................................................................................, the Main Supervisor for
Master PhD

Siti Nur Azrreen Binti Ruslan
Mr/Mdm/Ms ..........................................................who is the candidate for
have been informed of his/her intention to submit three (3) copies of thesis for oral examination

Therefore, I verify that I am fully satisfied with the progress made by this candidate and
have no objection for this candidate to submit three (3) copies of thesis to be examined
by the faculty.

................................................................ ...............................
(Signature of Main Supervisor) (Date)

Name of Co-Supervisor (If any) :

VERIFICATION BY DEAN OF FACULTY

Section C : (To be completed by Dean, Faculty/Centre)

I, .................................................................................., as the Dean, Faculty/Centre .......................

............................................................................ verify that declaration made by Main Supervisor of
this candidate as stated in Section B above.

Faculty/Centre forwards the following name as a moderator for this candidate:-

MODERATOR
Name : .................................................................
Address: : .............................................................
..............................................................
E-mail : ................. ...........
Tel : ........................... Fax : ...............................

................................................................. ....................
(Signature of Dean and Official Stamp) (Date)