COURSE REGISTRATION FORM UTM.

E/3-1
PLEASE READ CAREFULLY, REFER TO THE GUIDELINES (Amendment 1/08)

MUHAMMAD FURQAN BIN ABDULLAH

Student’s Name : _____________________________________________________________________________
(In BLOCK letters and as stated in Identity Card/Passport)

Matric Card No. : M I C 2 0 3 0 0 9 Session/Semester : 2 0 2 2 2 0 2 3 / 2

Identity Card/ : 9 2 0 5 2 6 0 1 5 6 9 9 Total Credit Transferred :

Passport No.
2 0 2 3 furqanyarmouk@gmail.com
Year/Program : Email : ______________________________________________________

Please fill in the boxes clearly and correctly. If you are registering for more than 12 courses, please use two forms. Fill the code
‘UM’ in the status column for Repeat Course, ‘HW’ for the Compulsory Attendance ‘HS’ for Attendance Only ‘HWUM’ Compulsory
Attendance Repeat Course.

NO. COURSE CODE SECTION STATUS CREDIT LECTURER’S SIGNATURE

1. M I C H 3 2 0 0 1 0
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
Total Credit (Exclusive of ‘HS’ courses)

Mailing
Address : NO 6 JALAN WIDURI 2 KAMPUNG SENTOSA JAYA

Postcode 7 0 4 0 0 Town or State SEREMBAN

I intend to register for the courses above. Agree/Disagree

______________________________________ ______________________________________
(Student’s Signature) (Academic Advisor’s or Supervisor’s Signature)
0163722985
Mobile Phone No : _______________________ Name: ________________________________
Tel. Extension: ________________________
07 06 2023
Date: ______/________/__________ Date: _________/_________/__________

IF THE ACADEMIC ADVISOR OR SUPERVISOR DISAGREE

Dean’s/Deputy Dean’s of Academic Decision Approved/Not Approved

(First Copy – Faculty’s Use)
Signature _______________________ Date ______/_______/_____

(1st copy – Faculty Office, 2nd copy – Academic Advisor, 3rd copy – Student)