PASTE YOUR PICTURE HERE[ SEKRETARIAT CHEST 15/16 ]APPLICATION FORMSEKRETARIAT CHEST 15/16UNIVERSITI MALAYSIA PAHANG

A. Maklumat Peribadi Pemohon ( Sila Gunakan HURUF BESAR ) Applicant Information ( Please Use CAPITAL LETTER )Nama Penuh / Fullname : ..............................................................................................................................No. Kad Pengenalan / IC No. : ............................................................. ID No.: .........................................Alamat Rumah / Home Adress : .............................................................................................................................................................................................................................................................................................Poskod / Postcode : ....................... Bandar/ City : ............................. Negeri/ State : ............................Jantina / Gender ( Male/Female ) : .................................... Agama / Religion : .........................................Bangsa/ Race : ..................... Umur/ Age : ........... Warganegara/ Nationality : ................................... Kolej Kediaman / Residential College ( KK 1/KK2/KK3/KK4/KK5 ) : ......... No. Bilik / Room No : ..................Alamat Email / Email Adress : ................................................... Nama FB : .............................................

B. Maklumat Akademik Pemohon (Sila Gunakan HURUF BESAR ) Applicant Academic Information ( Please Use CAPITAL LETTER )Kursus Pengajian / Course : ...........................................................................................................................Tahun Pengajian / Years of Study ( 1 / 2 / 3 / 4 ) : ................... PNGK Terkini / Latest CGPA : ......................Nama Penasihat Akademik / Name of Academic Advisor : ...........................................................................Penaja / Scholarship / Pinjaman Pengajian / Education Loan : ......................................................................

C. Soal Selidik Questionnaires 1. Penglibatan dalam aktiviti Kokurikulum / Jawatan / Involvement in Cocuriculum Activities / Position in Club i) ...................................................................................................................................................................ii) ...................................................................................................................................................................iii) ...................................................................................................................................................................(Bulatkan jawapan yang dipilih)( Circle the answer that you have selected )1. Saya mempunyai pengalaman menjadi sekretariat CHEST sebelum ini. ( YA / TIDAK ) I have the experience became as previous CHEST secretariat ( YES / NO ) Jika ''YA'' , sila nyatakan anda sekretariat dibawah exco mana : ............................................................... If ''YES'' , please state you under what exco : ............................................................................................2. Saya taat mengerjakan amalan dalam agama saya anuti. ( YA / TIDAK ) I do practice the religion that I belong obediently. ( YES / NO )3. Saya sentiasa memelihara imej dan sahsiah saya sebagai seorang pelajar UMP sama ada dalam atau luar kampus ( YA / TIDAK ) I always keep my image and personality as a UMP student either in or outside campus. ( YES / NO )4. Saya berminat untuk hadir ke setiap program CHEST yang dianjurkan ( YA / TIDAK ) I am very interested in attending the CHEST proggrammes ( YES / NO ) 5. Jika diberi pilihan, sekretariat pelaksana manakah yang menjadi 3 pilihan utama anda? If given a choice, which is the secretariat which suits you most three (3) ?. KERJAYA, INDUSTRI DAN ALUMNI / CAREER, INDUSTRY AND ALUMNI. DAYA SAING AKADEMIK DAN INOVASI / COMPETITIVENESS OF ACADEMIC AND INNOVATION. KHIDMAT MASYARAKAT, SUKAN DAN REKREASI / EXTERNAL RELATIONS, SPORTS AND RECREATION. KEPIMPINAN, NILAI TERAS DAN KOMUNIKASI / LEADERSHIP, CORE VALUE & KOMUNIKASI. KEUSAHAWANAN DAN PENJANAAN EKONOMI / ENTREPRENEURHIP AND GENERATION OF ECONOMICS i) ...................................................................................................................................................................ii) ...................................................................................................................................................................iii) ...................................................................................................................................................................