Form GF001

APPLICATION FORM
PAPER PRESENTATION (ORAL) – IPS
Graduate Fund
APPLICATION REQUIREMENTS/INSTRUCTIONS

1. Current full time postgraduate student of Universiti Sains Malaysia

2. Undertaking Masters/PhD programme by Research Mode

3. All applicants are required to submit their application six months prior the the date
of the conference with the requestd documents.

4. Submit completed application form with relevant documents to:

Dean
Institute of Postgraduate Studies
Universiti Sains Malaysia
11800 Minden, Penang
Malaysia

A. APPLICANT’S PARTICULARS

1. Name :

2. I/C / Passport No.: 3. Mailing Address:

4. E-mail : 5. Registration Date:

6. Telephone No. (Handphone) :

(Lab) :
7. Matric No: 8. School/Centre:

9. Current Degree: 10. Research Field:

11. Main Supervisor:

12. Co-Supervisor:
( if applicable )

13. Research Title:

B. CURRENT SCHOLARSHIPS/FINANCIAL ASSISTANCE/RESEARCH UNIVERSITY GRANT

IPS Graduate Fund Application Form 1
GF001, Universiti Sains Malaysia
(if any)

1. Sponsor

2. Type Scholarship / Loan / Scheme / Research University Grant (e.g.

USM-RUPRGS)
3. Amount

4. Duration From: ………………………………… To: …………………………………

C. RESEARCH EXPERIENCE
(If applicable; please provide evidence)
1.

2.

3.

D. PUBLICATIONS
(If applicable; please provide a copy of the first page of your article in the journal)
1.
2.
3.

E. DECLARATIONS

E1. I declare that I am not a recipient of any other scholarship or financial aid

Name :

Signature :

Date :

E2. I hereby certify that all information given in this application is complete and correct to the
best of my knowledge

Name :

Signature :

Date

FOR PAPER PRESENTATION (ORAL) ONLY

Please provide
1. Full paper ready for publication

IPS Graduate Fund Application Form 2

GF001, Universiti Sains Malaysia
 2. Details of conference (e.g. brochures, pamphlet, details of keynote speakers
etc)
3. Quotations of travel expenses

1. Name of Conference

2. Organiser

3. Venue of Conference
(City, Country)

4. Date of Conference

5. Deadline for Registration

Fee

6. Title of Paper for Oral Presentation

7. Conference Publication (if known) (Please tick)

Categories Title / Volume /
a. Peer-Reviewed Journal

b. Proceedings with ISBN

c. Unreviewed Proceeding /
Extended Abstract
(if yes, please proceed to
section 8)
No Information

8. Post Conference Publication

Upon completion of this conference, I plan to
8a. Submit my paper for publication in (state name of journal)

_________________________________________________________________________________________ or

8b. Submit my paper for publication to the USM journal (state which journal)
(Please choose from the list provided)
______________________________________________________________________________________

IPS Graduate Fund Application Form 3

GF001, Universiti Sains Malaysia
 List of USM Journal [Visit www.penerbit.usm for further details]

Asian Academy of Management Journal

Asian Academy of Management Journal of Accounting and Finance
Bulletin of the Malaysian Mathematical Society
International Journal of Asia Pacific Studies
WACANA SENI Journal of Arts Discourse
Journal of Educators and Education
Journal of Engineering Studies
Journal of Physical Science
Tropical Life Sciences Research (Journal of Bioscience)
Journal of Construction in Developing Countries
KEMANUSIAAN The Asian Journal of Humanities (Jurnal Ilmu Kemanusiaan)
Kajian Malaysia
Malaysian Journal of Distance of Education
Malaysian Journal of Medical Sciences
Malaysian Journal of Pharmaceutical
Others (please specify)

9. Budget
(Please indicate estimated budget for paper presentation)

Particular Type of transportation (Please Cost (RM)

s circle & state name)

To Date : Airline System/

Bus/Train :
*
Transportati
on Retur Date : Airline System/
Cost n Bus/Train :

Total

Registration
Fees

Total
Amount

* For international conferences: On budget airlines where available. Please provide details of
flight quotations from
USM Panel Travel Agents. Other ground arrangement cost to be borne by students.
[Example of ground arrangement: Heathrow Airport to hotel or place of conference]

For conferences within the West Malaysia, only by ground travel (public transport, etc. only by
train/bus) is allocated
and supported. Students may not claim mileage. Other ground arrangement cost to be
borne by students.
[Example of ground arrangement: Bus/railway station to hotel or place of conference]

UNIVERSITI SAINS MALAYSIA

PANEL FLIGHT AGENTS

IPS Graduate Fund Application Form 4

GF001, Universiti Sains Malaysia
 No Name of Agent Address Contact No.
.

1 Arabtco Travel & Tours No. 18, 1st Floor, Jalan Usahawan 2 04 – 5755 634
Sdn. Bhd Pusat Perniagaan
13200 Kepala Batas, Pulau Pinang

2 Bayan Baru Travel Sdn Bhd Unit 488, D-04-05 04 – 2298 255
Midlands Park Centre 04 – 2278 258
Jalan Burmah, 10350 Pulau Pinang 04 – 2281 305
04 – 2280 276

3 Hayi Travel & Tours Sdn. Tingkat Bawah Kompleks Yakin 09 – 7419 205
Bhd Jalan Gajah Mati 09 – 7419 206
15000 Kota Bharu, Kelantan

4 Magna Bridge Travel & Head Quarter 03 – 5513 1559

Tours Sdn Bhd 6-4 Pusat Dagangan UMNO
Shah Alam
Pe4siaran Damai Seksyen 11
401000 Shah Alam, Selangor

5 Rakyat Travel Sdn Bhd 2nd Floor, Bank Rakyat Building 04 – 2624 488
No. 137 Jalan Magazine
10300 Georgetown, Pulau Pinang

6 Redland Holiday Travel & No. 7, Wisma Redland 03 – 8024 8171

Tour Sdn Bhd Jalan USJ 1/1C 03 – 8024 9171
Regalia Business Centre
47620 Subang Jaya, Selangor

7 Asari Murni Sdn. Bhd No. 32A, Tingkat 1 04 – 5402 929

Jalan Perda Barat, Bandar Perda 04 – 5402 928
14000 Bukit Mertajam, Pulau Pinang

8 Awan Travel Sdn Bhd B-4, Bangunan Mara 04 – 2620 105

No. 5, Lebuh Buckingham
10200 Pulau Pinang

9 Kejora Travel & Agencies No. 2779, Jalan Chain Ferry 04 – 3971 100
Sdn Bhd Taman Inderawasih
13600 Perai, Pulau Pinang

10 MIVS Travel & Air Cargo No. 1, Lebuh Buckingham 04 – 2614 448
Agencies Sdn Bhd 10200 Georgetown, Pulau Pinang 04 – 2616 036

11 Suria Class Travel & 8E – G, Jalan Tun Dr. Awang 04 – 6461 766
Agency Sdn Bhd 11900 Pulau Pinang

12 Suria Indah Holiday Sdn 3A-4-43, Kompleks Bukit Jambul 04 – 6433 585
Bhd Jalan Rumbia
11900 Pulau Pinang

13 Tabung Haji Travel & 2828-G-1A, Bangunan NB Tower 04 – 3222 133

Services Jalan Bagan Luar
12000 Butterworh, Pulau Pinang
9 September 2009

SUPERVISOR’S REPORT
(Confidential report – to be filled by Main Supervisor)
1. Name:-

2. School/Centre:-

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GF001, Universiti Sains Malaysia
3. Candidate’s Name:-

4. Candidate’s Research Area:-

5. Research Programme Related to Candidate’s Research:-

6. Post-Conference Publication (please circle)

I agree/disagree that this paper can be submitted for publication in a peer-

reviewed journal after this conference.

7. Please State:-

a. Candidate’s involvement and ability to conduct research:

………………………………………………………………………………………………………………………
……………………………………………………

………………………………………………………………………………………………………………………
……………………………………………………

………………………………………………………………………………………………………………………
……………………………………………………

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……………………………………………………

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……………………………………………………

b. Potentials of the research area:

………………………………………………………………………………………………………………………
……………………………………………………

………………………………………………………………………………………………………………………
……………………………………………………

………………………………………………………………………………………………………………………
……………………………………………………

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……………………………………………………

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……………………………………………………

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GF001, Universiti Sains Malaysia
c.Supervisor’s Recommendation:

………………………………………………………………………………………………………………………
……………………………………………………

………………………………………………………………………………………………………………………
……………………………………………………

………………………………………………………………………………………………………………………
……………………………………………………

………………………………………………………………………………………………………………………
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………………………………………………………………………………………………………………………
……………………………………………………

Signature: Official Stamp:

Name:

Date:

-------PLEASE LEAVE THIS SECTION BLANK FOR OFFICIAL USAGE-------

F. SCHOOL DEAN/CENTRE DIRECTOR’S ENDORSEMENT

 Endorsed

 Not endorsed

Comment:

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

Signature : Official Stamp :

Name :

IPS Graduate Fund Application Form 7

GF001, Universiti Sains Malaysia
 Date :

PAPER PRESENTATION (ORAL) REPORT – IPS

Graduate Fund
To be submitted within 2 weeks after attending conference to Dean, Institute of
Postgraduate Studies, Universiti Sains Malaysia, 11800 USM, Pulau Pinang
(Attention: Hani Soraya Ahmad).

Please attach the relevant documents or the report will be considered incomplete and
shall not be processed.

A. PERSONAL DETAILS
Name

Matric Number Degree

Registration
Date

School/Centre

Contact Number E-mail

Main Supervisor

B. ATTENDED CONFERENCE DETAILS

Conference Date

Conference Title

IPS Graduate Fund Application Form 8

GF001, Universiti Sains Malaysia
Location

Objective

Conference
activities

C. APPROVED FUNDING BY IPS

Item RM
C1. Registration Fees

C2. Transportation (flight/train/bus)

Total

D. BUDGET REPORT (attach original receipt)

Item RM
D1.

D2.

Total

PAPER PRESENTATION (ORAL) REPORT – IPS

Graduate Fund

E. POST CONFERENCE PUBLICATION

E1. Please tick where appropriate (attach acknowledgement of manuscript

submission)

Publication Category

1. Peer-reviewed Journal (other than USM Tick (if any)

Journal):
(State name of journal here):

2. USM Journal (Visit www.penerbit.usm for Tick (if any)

futher details)
Asian Academy of Management Journal
Asian Academy of Management Journal of
Accounting and Finance
Bulletin of the Malaysian Mathematical Society
International Journal of Asia Pacific Studies
WACANA SENI Journal of Arts Discourse
Journal of Educators and Education
Journal of Engineering Science
Journal of Physical Science
Tropical Life Science Research (Journal of
Bioscience)
Journal of Construction in Developing Countries
KEMANUSIAAN The Asian Journal of Humanities
IPS Graduate Fund Application Form 9
GF001, Universiti Sains Malaysia
 (Jurnal Ilmu Kemanusiaan)
Kajian Malaysia
Malaysian Journal of Distance Education
Malaysian Journal of Medical Sciences
Malaysian Journal of Pharmaceutical

3. Proceedings with ISBN (please state):

4. Others (if any):

F. MAIN SUPERVISOR’S COMMENT

Name of Supervisor Official Stamp

Signature:

Date
Student’s signature
Date

IPS Graduate Fund Application Form 10

GF001, Universiti Sains Malaysia