CLEARANCE FORM

INSTRUCTION: Clearance Form MUST BE produced during the Pre-Registration Day and at Collection of Scroll / Transcript counter.

SECTION A: Graduates is required to fill up details in Section A and Item 7 Graduate Acknowledgement in Section B.

NAME PROGRAM

MATRIC NO CONTACT NO
STUDENT Main Regional KFORCE GRADUATION 2022 2021 2020
YEAR
Campus Centre
CATEGORY
SECTION B: For office use only

1. MOHE TRACER STUDY 2. KMC & ACCOMMODATION 3. REGISTRATION

Knowledge Management Centre (KMC) RSVP:
Yes No
Book(s) Fine (RM…………........) Yes No

Officer’s Signature & Stamp: Officer’s Signature: Registration Completed

Date: Date:
No of Scroll:

Accommodation/Hostel
Outstanding No Outstanding
Outstanding (RM………………….…..)
Officer’s Signature & Stamp:

Officer’s Signature: Date:

Date:

5. FINANCE 5. ROBE & RFID CARD COLLECTED 6. ROBE RETURNED

Eligible to attend Convo: Yes No

Yes No
Yes No

Officer’s Signature & Stamp: Officer’s Signature & Stamp:

Release of Scroll/Transcript:
Date: Date:
Yes No

Outstanding (RM……………………...)

Officer’s Signature & Stamp: *For 2020 & 2021 Graduates, RM200
Refundable Deposit will be refunded back to
Date: graduates by 19 December 2022, subject to
robes are returned by 1 December 2022.

7. GRADUATE ACKNOWLEDGEMENT REMINDER

I hereby confirm: 1. Graduates MUST complete the MOHE Tracer Study prior to registering for the convocation.
2. Graduates MUST register at Convocation Registration Counter for registration, verification
I have collected my scroll & transcript and collection of Convocation Invitation Card at Main Campus on 22nd – 23rd November
and all the information on my scroll & 2022.
transcript is correct. 3. Please keep this form for Robe return and Scroll/Transcript Collection after the
convocation ceremony.
Graduate’s Signature: 4. If the graduates wish to courier the Scroll & Transcript to Home/Office address, graduates
are required to pay RM 10.00 for the postage fee.
5. Fine or penalty of RM 50.00 per day will be imposed upon Graduate who returns the
Date: Academic Robe after 1 December 2022.
6. Please do not use high temperature during ironing of robes. Graduates will be charged
for any defect (if any).