INCENTIVE CLAIM FORM FOR PUBLICATION AND INTELLECTUAL PROPERTY

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SEGi UNIVERSITY SEGI COLLEGE____________ OTHERS____________

(Please tick) (Please specify)

Name: _________________________________________________________________________

Department & Designation: ____________________________Date Joined: __________________

Research Grant Value: RM __________________________ Sponsor: _______________________

Application for Publication of Article / Book / or Patent [please mark the relevant item]:

Publication Patent
Subject Category:
(Please complete section A only) (Please complete section B only)

Section A: Information on Publication

Title of Research:

Source of Finding: Grant Amount: RM

Title of Publication:

Full Journal Title:

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International Standard Volume /

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Impact Factor:
ISI / …)

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Article is an introduction and presentation of new research for scrutiny

Article is a critique of existing research

Section B: Information on IPR

Patent/ID Title:

When Filed: Patent No.:

Pending Approve
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Documentary Support: Yes / No

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Patent is IPR for research.

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