PBS/REQUEST FOR OFFICIAL FORM LETTER FOR PUTRA STUDENTS/LLD001

Learning Liaison Department

LLD001 REQUEST FOR OFFICIAL FORM LETTER FOR PUTRA STUDENTS
A. FOR THE PURPOSE OF:
Confirmation of Student Status

EPF Withdrawal

PTPTN / MARA / Scholarship / Loan

Trimester / Semester Result

Current trimester/semester Trimester(s)/Semester(s): ___________________
Mid-Term Exam / Final Exam Leave *
* Please list all the courses and the dates of examination for those particular trimester(s)/semester(s):

Name of Course Name of Course Name of Course

& Course Code: & Course Code: & Course Code:
1 2 3
Date of Date of Date of
Examination: Examination: Examination:

Name of Course Name of Course Name of Course

& Course Code: & Course Code: & Course Code:
4 5 6
Date of Date of Date of
Examination: Examination: Examination:

Data Collection

Project Paper / Case Study

Please Specify: ___________________________________________________________________________________________________________

Others
Please Specify: ___________________________________________________________________________________________________________

B. STUDENT DETAILS:
Name: Programme: MBA / MM (IT) / MSc / PhD
Programme Status: FULL-TIME / PART-TIME
Matric No.: IC/Passport No.:

Contact No.: Email Address:

Attention to Address of the

(recipient): recipient:

Additional information to be included in the letter (if any):

Please provide your address if you would like us to send you the letter:

C. FOR OFFICE USE ONLY

Received Date:
Prepared by (Name & Signature):
Completed Date:

Updated 31/12/2015