REGISTRATION FOR

NEW POSTGRADUATE STUDENTS

ITEMS PAGE

Steps for Registration – Research Mode Students 1

Steps for Registration – Coursework/Mixed Mode Students 2

Checklist for Registration 3

Medical Examination Report – For Immigration Purpose 4

Medical Examination Report – Copy for USM 9

Confirmation of Registration Form 14

Change of Address Form 15

Smart Card Application Form 16

Important Contact Details 17

 INSTITUT PENGAJIAN SISWAZAH
INSTITUTE OF POSTGRADUATE STUDIES

STEPS FOR REGISTRATION - RESEARCH MODE STUDENTS

Start

Ensure the required document for registration as listed on Page 3 is ready

Verification of Medical
Report at USM Wellness
Centre (Ensure the original YES
form is attached with photo International
and bring along original lab student?
reports for verification)

NO

Checking of document at IPS Counter

Make payment for tuition fee at Bursary Counter

Registration confirmation and profile update at IPS Counter

Submit PASSPORT, copy

of Medical Report and Issuance of Smart Card at Smart Card Counter
Student Pass fee to USM
Visa Unit

Smart-card will be hold

until completion of Student
Pass endorsement. YES
International
Copy of Student Pass student?
need to be submitted to
IPS for Smart Card
collection.
NO

i. Activation of official email address

ii. Visit Library to activate Smart Card usage for library services

End

1
 INSTITUT PENGAJIAN SISWAZAH
INSTITUTE OF POSTGRADUATE STUDIES

STEPS FOR REGISTRATION - COURSEWORK MODE / MIXED MODE STUDENTS

Start

Acceptance of Offer

Registration Fee Payment

Self Enrolment (Student Email Registration)

Self Upload (Smart Card)

Course Registration and Tuition Fee Payment

Verification of Medical Report

at USM Wellness Centre
YES
(Ensure the original form is International
attached with photo and bring student?
along original lab reports for
verification)

NO

Self Registration at IPS

Submit PASSPORT, copy of

Medical Report and Student YES
International
Pass fee to USM Visa Unit
student?
Smart-card will be hold until
completion of Student Pass
endorsement.
NO
Copy of Student Pass need to
be submitted to IPS for Smart
Card collection.

Visit Library to activate Smart Card usage for library services

End

2
 Checklist for Registration

INSTITUT PENGAJIAN SISWAZAH

INSTITUTE OF POSTGRADUATE STUDIES

Please ( ) at the space provided.

SECTION A (Applicable for both Local and International Student).

Checklist for documents that need to be submitted during registration

1. Confirmation of registration form
2. Medical examination report, X-ray report and all lab reports
(1 set of form marked For USM at top right corner)
3. Copy of payment receipt
4. Change of address form (if necessary)
5. Smart Card application form (if necessary)
6. Copy of scholarship/sponsorship letter of offer (if any)
7. Copy of latest bank statement -1 month prior to registration * applicable for International Student

SECTION B (Applicable for both Local and International Student).

Checklist for original documents that candidate needs to bring during registration

1. Original degree scrolls

2. Original academic transcripts
3. Receipt of payment
4. Scholarship/sponsorship letter of offer (if any)
5. Student pass approval letter from the Malaysian Immigration* applicable for International Student

3
 For Immigration purposes
(Applicable to international candidate only)

MEDICAL EXAMINATION REPORT

FOR INTERNATIONAL STUDENT AND Affix passport
ACCOMPANYING PERSON size photo
here
(blue background)

PLEASE USE CAPITAL LETTERS

SECTION 1 (TO BE COMPLETED BY CANDIDATE)
(PART A)
FULL NAME (AS IN PASSPORT)

INTERNATIONAL PASSPORT NO.

NATIONALITY

DATE OF BIRTH AGE CONTACT NO.

D D M M Y Y
GENDER MARITAL STATUS
ACADEMIC YEAR MALE SINGLE
/ FEMALE MARRIED

PROGRAMME
MASTER
DOCTORATE
SCHOOL / CENTRE

NEXT OF KIN (RELATIVES)

NEXT OF KIN'S ADDRESS

NEXT OF KIN'S CONTACT NUMBER

4
 For Immigration purposes
SECTION 1 (Applicable to international candidate only)
(PART B) - Please tick ( ) in the relevant box
Declaration of self and family illness. Explain in full if you or your family has any of the following illness.
• Immediate family refers to father, mother, brothers / sisters

SELF IMMEDIATE
If "Yes" please state
MEDICAL PROBLEMS FAMILY
Yes No Yes No
1. Congenital or inherited disorder
2. Allergy
3. Mental illness
3. Fits, stroke, other neurological disease
5. Diabetes Mellitus
6. Hypertension
7. Heart or vascular disease
8. Asthma
9. Thyroid disease
10. Kidney disease
11. Cancer
12. Tuberculosis
13. Drug addiction
14. AIDS, HIV
15. History of surgery
16. Other illness

Current medication (Long term)

IMMUNISATION HISTORY
(where applicable) DATE IMMUNISED

1. Yellow Fever
2. BCG*
3. Meningitis (Quadrivalent)*
4. Hepatities B*
5. Others
* Applicable for international candidates only.

I hereby certify that the information given above is true. I understand that my application will be rejected
if there is any false information given.

Date Signature of candidate

5
SECTION 2 - PHYSICAL EXAMINATION For Immigration purposes
(Applicable to international candidate only)
To be filled by examining doctor

1. BASIC MEASUREMENT
HEIGHT : m BLOOD PRESURE : mmHg
WEIGHT : kg PULSE RATE : / min
VISION TEST : Unaided : (R) (L) COLOUR VISION TEST :
Aided : (R) (L) NORMAL / ABNORMAL

2. GENERAL EXAMINATION
ITEM YES NO COMMENT
a. DEFORMITIES
b. PALLOR
c. CYANOSIS
d. JAUNDICE
e. OEDEMA
f. SKIN DISEASES

3. SYSTEM EXAMINATION
ITEM NORMAL ABNORMAL COMMENT
a. EYES (Including funduscopy)
b. EARS
c. NOSE
d. ORAL CAVITY / THROAT
e NECK
f. HEART
g. LUNGS
h. ABDOMEN / HERNIAL ORIFICES
j. MENTAL CONDITION
k. MUSCULOSKELETAL SYSTEM

6
 For Immigration purposes
SECTION 3 - INVESTIGATIONS (Applicable to international candidate only)
To be filled by examining doctor.

URINE TEST (Please attach all the original lab report)

ITEM DATE TAKEN RESULT
a. ALBUMIN
b. SUGAR
c. MICROSCOPIC
d. MORPHINE*
e. CANNABIS*
f. AMPHETAMINES TYPE STIMULANT*
* Applicable for international candidates only.

BLOOD TEST (Please attach all the original lab report)

ITEM DATE TAKEN RESULT
a. HEPATITIS Bs ANTIGEN*
b. HEPATITIS C*
c. HIV*
d. VDRL / TPHA*
e. MALARIAL PARASITE*
* Applicable for international candidates only.

CHEST X-RAY INFORMATION

CHEST X-RAY NO.

DATE TAKEN

PLACE TAKEN

REPORT

7
SECTION 4 - CERTIFICATION BY THE EXAMINING DOCTOR For Immigration purposes
(Applicable to international candidate only)
Please tick ( ) in the appropriate box

I certify that I have on this date examined

Mr. / Ms.
Passport No. and found him / her -

IN GOOD HEALTH

HAVING THE FOLLOWING MEDICAL COMPLICATION(S) (Please State)

UNDERGOING TREATMENT FOR: (Please State)

Date Signature of Doctor

Name of Doctor
Qualification
Hospital / Clinic
Registration Number
Official Stamp

Remarks by University / College Official

8
 Copy for USM
(Applicable to local/international candidate)

MEDICAL EXAMINATION REPORT

FOR LOCAL / INTERNATIONAL STUDENT Affix passport
AND ACCOMPANYING PERSON size photo here
(blue
background)

PLEASE USE CAPITAL LETTERS

SECTION 1 (TO BE COMPLETED BY CANDIDATE)
(PART A)
FULL NAME (AS IN PASSPORT / IC)

INTERNATIONAL PASSPORT NO.

I/C NO.

NATIONALITY

DATE OF BIRTH AGE CONTACT NO.

D D M M Y Y
GENDER MARITAL STATUS
ACADEMIC YEAR MALE SINGLE
/ FEMALE MARRIED

PROGRAMME
MASTER
DOCTORATE
SCHOOL / CENTRE

NEXT OF KIN (RELATIVES)

NEXT OF KIN'S ADDRESS

NEXT OF KIN'S CONTACT NUMBER

9
 Copy for USM
SECTION 1 (Applicable to local/international candidate)

(PART B) - Please tick ( ) in the relevant box

Declaration of self and family illness. Explain in full if you or your family has any of the following illness.
• Immediate family refers to father, mother, brothers / sisters

SELF IMMEDIATE
If "Yes" please state
MEDICAL PROBLEMS FAMILY
Yes No Yes No
1. Congenital or inherited disorder
2. Allergy
3. Mental illness
3. Fits, stroke, other neurological disease
5. Diabetes Mellitus
6. Hypertension
7. Heart or vascular disease
8. Asthma
9. Thyroid disease
10. Kidney disease
11. Cancer
12. Tuberculosis
13. Drug addiction
14. AIDS, HIV
15. History of surgery
16. Other illness

Current medication (Long term)

IMMUNISATION HISTORY
(where applicable) DATE IMMUNISED

1. Yellow Fever
2. BCG*
3. Meningitis (Quadrivalent)*
4. Hepatities B*
5. Others
* Applicable for international candidates only.

I hereby certify that the information given above is true. I understand that my application will be rejected
if there is any false information given.

Date Signature of candidate

10
 Copy for USM
(Applicable to local/international candidate)
SECTION 2 - PHYSICAL EXAMINATION
To be filled by examining doctor

1. BASIC MEASUREMENT
HEIGHT : m BLOOD PRESURE : mmHg
WEIGHT : kg PULSE RATE : / min
VISION TEST : Unaided : (R) (L) COLOUR VISION TEST :
Aided : (R) (L) NORMAL / ABNORMAL

2. GENERAL EXAMINATION
ITEM YES NO COMMENT
a. DEFORMITIES
b. PALLOR
c. CYANOSIS
d. JAUNDICE
e. OEDEMA
f. SKIN DISEASES

3. SYSTEM EXAMINATION
ITEM NORMAL ABNORMAL COMMENT
a. EYES (Including funduscopy)
b. EARS
c. NOSE
d. ORAL CAVITY / THROAT
e NECK
f. HEART
g. LUNGS
h. ABDOMEN / HERNIAL ORIFICES
j. MENTAL CONDITION
k. MUSCULOSKELETAL SYSTEM

11
 Copy for USM
(Applicable to local/international candidate)
SECTION 3 - INVESTIGATIONS
To be filled by examining doctor.

URINE TEST
ITEM DATE TAKEN RESULT
a. ALBUMIN
b. SUGAR
c. MICROSCOPIC
d. MORPHINE*
e. CANNABIS*
f. AMPHETAMINES TYPE STIMULANT*
* Applicable for international candidates only.

BLOOD TEST (Please attach all the original lab report)

ITEM DATE TAKEN RESULT
a. HEPATITIS Bs ANTIGEN*
b. HEPATITIS C*
c. HIV*
d. VDRL / TPHA*
e. MALARIAL PARASITE*
* Applicable for international candidates only.

CHEST X-RAY INFORMATION

CHEST X-RAY NO.

DATE TAKEN

PLACE TAKEN

REPORT

12
 Copy for USM
(Applicable to local/international candidate)
SECTION 4 - CERTIFICATION BY THE EXAMINING DOCTOR

Please tick ( ) in the appropriate box

I certify that I have on this date examined

Mr. / Ms.
IC / Passport No. and found him / her :-

IN GOOD HEALTH

HAVING THE FOLLOWING MEDICAL COMPLICATION(S) (Please State)

UNDERGOING TREATMENT FOR: (Please State)

Date Signature of Doctor

Name of Doctor
Qualification
Hospital / Clinic
Registration Number
Official Stamp

Remarks by University / College Official

13
 INSTITUT PENGAJIAN SISWAZAH
INSTITUTE OF POSTGRADUATE STUDIES

BORANG PENGESAHAN PENDAFTARAN

(CONFIRMATION OF REGISTRATION FORM)
NAMA PENUH / (FULL NAME):

NO. KAD PENGENALAN / (I/C NO.): NO. PASPORT / (PASSPORT NO.):

PUSAT PENGAJIAN / PUSAT / INSTITUT (SCHOOL / CENTRE / INSTITUTE)

A. IJAZAH (DEGREE)

DOKTOR FALSAFAH / KEDOKTORAN (PhD / Doctoral)

SARJANA (Masters)

B. JENIS PENCALONAN (CANDIDATURE TYPE)

PENUH MASA SAMBILAN TIDAK BERKENAAN

(Full Time) (Part Time) (Not Applicable)

Pengakuan Pelajar / (Declaration)

Dengan i n i saya bersetuju bahawa hakcipta sesuatu tesis adalah hakmilik pelajar. Walau
bagaimanapun, sebagai syarat untuk dianugerahkan sesuatu ijazah, saya dengan ini
memberikan hak tanpa sebarang balasan, secara berterusan, bukan eksklusif dan bebas
royalti untuk Universiti menggunakan kandungan kerja dan/atau tesis tersebut untuk
kegunaan pengajaran, penyelidikan dan tujuan promosi di samping hak bukan eksklusif
kepada Universiti, untuk menyimpan, mengguna, menghasilkan semula, mempamer dan
mengedarkan salinan karya tesis tersebut, bersama-sama dengan hak untuk penerbitan
bagi tujuan penyelidikan masa hadapan dan arkib.
(I agree that the copyright to a thesis belongs to the student. However, as a condition of
being awarded the degree, I hereby grants to the University, a free, ongoing, non-exclusive
right to use the relevant work and/or thesis for the University's teaching, research and
promotional purposes as well as free and the non-exclusive right to retain, re-produce,
display and distribute a limited number of copies of the thesis, together with the right to
require its publication for further research and archival use).

Tarikh (Date):
Tandatangan Calon (Signature of Candidate)
UNTUK KEGUNAAN INSTITUT PENGAJIAN SISWAZAH
(For IPS Of f ice Use Only)

Tarikh Pendaftaran
Pengesahan Staf IPS

14
 INSTITUT PENGAJIAN SISWAZAH
INSTITUTE OF POSTGRADUATE STUDIES

BORANG MENUKAR ALAMAT

(CHANGE OF ADDRESS)

1. NAMA (DALAM HURUF BESAR) / NAME (IN CAPITAL)

2. NO. MATRIK (MATRIC NO.)

3. NO. KAD PENGENALAN (PASSPORT NO.)

4. ALAMAT SURAT MENYURAT (CORRESPONDENCE ADDRESS)

BANDAR (STATE) NEGARA (COUNTRY)

POSKOD (POSTCODE) NO. TELEFON (TELEPHONE NO.)

5. BUTIR-BUTIR ALAMAT TETAP (PERMANENT ADDRESS)

BANDAR (STATE) NEGARA (COUNTRY)

POSKOD (POSTCODE) NO. TELEFON (TELEPHONE NO.)

Tarikh / (Date):
Tandatangan (Signature)

KEGUNAAN PEJABAT (FOR OFFICE USE ONLY)

Tindakan oleh:

Nama & Tandatangan 15

Tarikh
 INSTITUT PENGAJIAN SISWAZAH
INSTITUTE OF POSTGRADUATE STUDIES

BORANG PERMOHONAN KAD PINTAR

(SMART CARD APPLICATION FORM)
NAMA PEMOHON / (APPLICANT'S NAME):
12 huruf sahaja / (12 characters only)

NO. MATRIK / (MATRIC NO.):

Tarikh / (Date):
Tandatangan Pelajar (Signature of Student)

KEGUNAAN PEJABAT (FOR OFFICE USE ONLY)

1. PENDAFTARAN DIRI LENGKAP TIDAK LENGKAP

Tarikh
Tandatangan Staf
2. PENGESAHAN SEMULA PERKARA YANG TIDAK LENGKAP

Tarikh
Disahkan oleh

KEGUNAAN PEJABAT (FOR OFFICE USE ONLY)

1. SESI FOTOGRAFI BERJAYA TIDAK BERJAYA

KOD BAR

2. KAD PINTAR DIAMBIL PADA

Tarikh
Disahkan oleh

Sila bawa bersama borang ini semasa mengambil kad pintar

(Please bring along this form during collection of the smart card)

16
 INSTITUT PENGAJIAN SISWAZAH
INSTITUTE OF POSTGRADUATE STUDIES

IMPORTANT CONTACT DETAILS

UNIT CONTACT NO. E-MAIL

ADMISSION Main Campus admission_ips@usm.my
(Registration matters) & +604 – 653 6027 mahani_yusoff@usm.my
(Postponement of registration date) +604 – 653 2946 siti_hajar@usm.my
+604 – 653 2937 farah_man@usm.my

Engineering Campus
+604 – 599 6528 siti.norlaila.ahmad@usm.my
+604 – 599 6527 rgmushlehat@usm.my
+604 – 599 6525 khairunisa@usm.my

Health Campus
+609 – 767 2382 ridhuan@usm.my
+609 – 767 2383 srimas@usm.my
BURSARY
(Fees related matters) +604 – 653 2995 hayaty@usm.my
record_ips@usm.my
FELLOWSHIP
(Financial Assistance) +604 – 653 2983 ynorashikin@usm.my
halizahassan@usm.my
VISA Main / Engineering
(Student Pass matters) Campus
+604 – 653 2493 visa@usm.my
+604 – 653 2774 fadzilla@usm.my

Health Campus
+609 – 767 2033 sulbahri@usm.my
ACCOMMODATION Main Campus
+604 – 653 4458 selihan_drani@usm.my
+604 – 653 4455

Health Campus
+609 – 767 1316 norashiken@usm.my
+609 – 767 1302 nliyana@usm.my
+609 – 767 1346

Engineering Campus
+604 – 599 1063 dunorzaide@usm.my

17
 INSTITUT PENGAJIAN SISWAZAH
INSTITUTE OF POSTGRADUATE STUDIES

SCHOOL/CENTRE/INSTITUTE PERSONNEL

MAIN CAMPUS
School of Housing, Building and Planning +604–653 6193 iftitah@usm.my
School of Industrial Technology +604–653 2218 nor_farah@usm.my
Graduate School of Business (GSB) +604–653 2795 fatimahbanu@usm.my
School of Biological Sciences +604–653 4035 alfakari@usm.my
School of Chemical Sciences +604–653 3540 haryani@usm.my
School of Communication +604–653 3600 nur_akmar@usm.my
School of Computer Sciences +604–653 3263 redzuan@usm.my
School of Distance Education +604–653 2302 syahnaz_riza@usm.my
School of Educational Studies +604–653 2049 bfaridah@usm.my
School of Humanities +604–653 3850 haslinda_yusof@usm.my
School of Languages, Literacies and Translation +604–653 4543 rasslene@usm.my
School of Management +604–653 3367 zzh@usm.my
School of Mathematical Sciences +604–653 2629 subrag@usm.my
School of Pharmaceutical Sciences +604–653 4593 moganes@usm.my
School of Physics +604–653 3025 naziroh@usm.my
School of Social Sciences +604–653 3362 ahmadzaki@usm.my
School of the Arts +604–653 3620 azimin_dzul@usm.my
Analytical Biochemistry Research Centre (ABrC) +604-653 4696 amiraazman@usm.my
Centre for Chemical Biology +604-653 5513 nurulamira_ali@usm.my
Centre for Drug Research +604-653 3274 hidayahrahman@usm.my
Centre for Global Archaeological Research +604-653 4148 azmandarus@usm.my
Centre for Global Sustainability Studies +604-653 2461 nazira_za@usm.my
Centre for Instructional Technology and Multimedia +604-653 3225 mohdzuki@usm.my
Centre for Islamic Development Management Studies +604-653 4601 kamarudin@usm.my
Centre for Marine and Coastal Studies +604-653 2604 skdef@usm.my
Centre for Policy Research and International Studies +604-653 3385 zuraida@usm.my
Institute of Nano Optoelectronics Research and Technology (INOR) +604-653 5646 azraai@usm.my
Institute for Research in Molecular Medicine +604-653 4807 rfauziah@usm.my
National Advanced IPV6 Centre +604-653 3001 malar@usm.my
National Higher Education Research Institute +604-653 5754 azmahani@usm.my
National Poison Centre +604-653 2078 rosilawaty@usm.my
Women’s Development Research Centre +604-653 3433 hasniza@usm.my

HEALTH & BERTAM CAMPUS

Advanced Medical & Dental Institute +604-562 2352 yusmadi@usm.my
Center for Neuroscience Services and Research +609-767 2357 ctsarah@usm.my
School of Dental Sciences +609-767 5522 abghani@usm.my
School of Health Sciences +604-767 7522 ithma@usm.my
School of Medical Sciences +604-767 6052 wnfajrina@usm.my
18
 INSTITUT PENGAJIAN SISWAZAH
INSTITUTE OF POSTGRADUATE STUDIES

ENGINEERING CAMPUS
River Engineering & Urban Drainage Research Centre +604-599 5464 redac11@usm.my
School of Aerospace Engineering +604-599 5967 zituakmar@usm.my
School of Chemical Engineering +604-599 5880 nrlinda@usm.my
School of Civil Engineering +604-599 6209 rgfarah@usm.my
School of Electrical and Electronic Engineering +604-599 6011 normala@usm.my
School of Materials and Mineral Resources Engineering +604-599 6168 hafiz_ali@usm.my
School of Mechanical Engineering +604-599 6305 mdkamal@usm.my

19
Version: November 2017

Institute of Postgraduate Studies

Universiti Sains Malaysia
11800 USM
Penang, MALAYSIA.
email : admission_ips@usm.my

www.admissions.usm.my