Borang Pemulangan Pelajar Tamat Pengajian

Institut Perubahan Iklim

Institute of Climate Change

BORANG PEMULANGAN: ALAT/DATA/ASET/KOMPUTER DAN TEMPAT PELAJAR
(RETURN FORM: EQUIPMENT/DATA/ASSET/COMPUTER AND STUDENT WORKPLACE)
Nama Pelajar:
Students’ Name:
Jabatan:
Department:
Emel Pelajar:
Students’ Email:
No. Telefon:
Mobile No:
Peringkat Pengajian:
Course Level:
Tarikh Tamat:
End Date:
Nama Penyelia:
Supervisor Name:

Sarjana (MSc) / Doktor Falsafah (PhD)

I have confirmed that: (please tick √ in the appropriate box)
TICK(√)

CONFIRMED BY
(Lab Assistant/
Science Officer)

ACKNOWLEDGEMENT
I have tidied up and returned all the UKM equipments/data/assets/computer
that were used during completing my research project.
Please list the equipments/data/assets/computer:

My research project does not involve or use any of the experimental and
laboratory equipment.
I have tidied up and cleared my workplace table and return the laboratory
and locker’s key that was used for research facilities during my research
project.
I did not set any password in the computer that I used.

(If any, please give the password here: ___________________________ )

Authorized by supervisor:
_________________________
Student’s name :
Date :

_______________________
Supervisor’s name:
Date :

Institut Perubahan Iklim (IPI),
Ibu Pejabat: Bangunan Pusat Pencerapan Bumi.
Pusat Pencerapan Bumi / Pusat Sains Angkasa / Pusat Sistem Perubahan Iklim Tropika
Universiti Kebangsaan Malaysia, 43600 UKM Bangi, Selangor Darul Ehsan
Telefon: +603-8921 6097/6772

Faksimili: +603-8921 6098 E-mel: pghikp@ukm.my