SSC/FORM/04 Ver.1, Rev.0 03/03/2014

STUDENTS SERVICE CENTER

EXTENSION OF STUDY PERIOD FORM

STUDENT ID NAME PROGRAMME PASSPORT NO. (FOR INTERNATIONAL STUDENT ONLY)

CONTACT NO .

PENDING SUBJECT/S: (Kindly bring your transcript/result online when meeting your faculty’s Administrator)

NO SUBJECT CODE SUBJECT NAME TRIMESTER

THAT THE SUBJECT/S WILL

BE OFFERED

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STUDENT’S SIGNATURE: _________________________ DATE : ____________________

REMARK BY THE FACULTY:

Tentatively, the above student will be graduated in _____________________________ (Month & Year)

VERIFIED BY : _____________________________________ DATE : ________________________ (with stamp)

* The information above will be updated in the Student Profile.

ST: