APPLICATION FORM

GRADUATE RESEARCH FUND

APPLICATION REQUIREMENTS/INSTRUCTIONS

1. Full time graduate student of Universiti Sains Malaysia.

2. Undertaking Masters/PhD programme by Research Mode

3. Submit completed application form to:

4.
Dean
Institute of Graduate Studies
Universiti Sains Malaysia
11800 Minden, Penang
Malaysia

A. APPLICANT’S PARTICULARS

1. Name (Please print/type):

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

4. E-mail: 5. Registration Date:

6. Telephone No. (Handphone) :
(Lab) :
7. Metric No: 8. School/Centre:

9. Degree: 10. Research Area:

11. Main Supervisor: 12. Co-Supervisor:

( if applicable )
13. Type of Support
(a) Research Grant ˆ
(b) Research Attachment ˆ
(c) Paper Presentation (Oral ˆ
Presentation Only)

14. Research Title:

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

Graduate Research Fund Application Form, Universiti Sains Malaysia 1

B. CURRENT AND PREVIOUS SCHOLARSHIPS (if any)

1. Sponsor

2. Type Scholarship/Loan Scholarship/Loan

3. Amount

4. Duration From: From:

To: To:

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

2.

3.

D. PUBLICATIONS
(If applicable; please provide copies)
1.

2.

3.

E. DECLARATION

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

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

Name : …………………………………………………………………

Signature : ………………………………………………………

Date : ……………………………….

Graduate Research Fund Application Form, Universiti Sains Malaysia 2

 RESEARCH GRANT

FOR RESEARCH GRANT ONLY

(Five (5) copies of this form (page 3 -5) must be submitted together with the Graduate Research Fund
Application Form to the Institute of Graduate Studies)
(i). Duration of project (not more than 12 month)s:

(ii). Location of research:

(iii). Research Summary Proposal *

(Include background literature, objectives, research methodology, flow chart, research gantt-
chart, list of research undertaken and published references.

(a) Background

__________________________________________________________________________

__________________________________________________________________________

__________________________________________________________________________

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(b) Objectives

__________________________________________________________________________

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(c) Research Methodology

__________________________________________________________________________

__________________________________________________________________________

__________________________________________________________________________

__________________________________________________________________________

__________________________________________________________________________

(d) Expected Outcomes

__________________________________________________________________________

__________________________________________________________________________

__________________________________________________________________________

__________________________________________________________________________

Graduate Research Fund Application Form, Universiti Sains Malaysia 3

* Please attach additional information if necessary / available
 (iv). Importance and benefits of research
Explain how your research contributes to the advancement of new knowledge

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

(v). Access to equipment and material

i) University

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

ii) Other sources

___________________________________________________________________________

___________________________________________________________________________

__________________________________________________________________________

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___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

Graduate Research Fund Application Form, Universiti Sains Malaysia 4

 (vi). Budget
Indicate estimated budget for the research proposal
Provide complete details of expenditure according to the guide attached

Budget details
Amount requested by Amount approved by
applicant JPDPS
Vot 21000
Travelling Expenses and Subsistence

Vot 22000
Transportation of Goods

*Vot 23000
Communication and Utilities (Phone,
Fax, Postage etc)

Vot 24000
Rental

Vot 25000
Food, Entertainment (coffee/tea/cakes) -
Beverage

*Vot 26000
Supply of Raw Materials & Materials for
Repairs & Maintenance

*Vot 27000

Research Materials & Supplies

(including Animals, Disposables, etc.)

Vot 28000
Maintenance and Minor Repair Services

Vot 29000
Professional services & other services
including printing & hospitality,
honorarium for subjects)

**TOTAL AMOUNT

* Applicants for Completion of Research Grant need to fill these Vots only
** Maximum RM 10,000.00

Date: _____________________ Applicant’s Signature _____________________

Graduate Research Fund Application Form, Universiti Sains Malaysia 5

GUIDELINES FOR EXPENDITURE

Vot 21000 – Travelling Expenses and Subsistence

To record claims by the academic staff while on official visit, including payment for personnel
transportation, personal subsistence, hotel and lodgings, toll and parking charges for project staff
appointed monthly, claims are according to their eligibility following the Circular 2 Year 1992, with
the exception of own transport at the rate of 60 cent/km. For other academic staff, travel
expenses and subsistence are according to Scale DS 2 (under the SBB Scheme), regardless of
their eligibility.

Vot 22000 – Transportation of Goods

To record the expenses for the transportation of goods within and outside the country. This also
includes the cost of operation and safekeeping during transportation of project equipment.
Charges include courier, insurance for parcels, storage charges and others.

Vot 23000 – Communication and Utilities

This vot records expenses relating to special services, examples : post, telephone, telex,
facsimile, cables and others. It also includes charges for electricity, water, gas and other utilities.
This vot includes installation and commissioning of equipments and phone rentals

Note : Please specify type of services requested, frequency of requirement and expected cost
incurred.

Vot 24000 - Rentals

To record all expenses for rentals, and leasing of land, building, vehicles, facilities and equipment.

Note : Must submit in the budget request, the type of rental needed, number and expected cost
incurred. Rentals of gas cylinders for liquid nitrogen, oxygen and others are included.

Vot 25000 – Food, entertainment (coffee/tea/cakes) – beverages

Vot 26000 – Supply of Raw Materials, and Materials for Repair and Maintenance.
To record expenses for all purchase of raw materials, and materials for repair and maintenance of
assets, example spare parts. This is only allowed for equipment bought using funds from this
grant. Payment for any services rendered for repair and maintenance should be placed under
Vote 28000

Vot 27000 – Research materials & supplies (including animals, disposables, etc.)
To document purchases of all supplies and materials not exceeding RM100.00 per item, which is
not categorized as an asset. It does not include materials and supplies under vot 26000. It
encompasses items such as chemical reagents, consumables, glassware, animals for research
and other relevant items.

Note: Please provide details of cost and quantity of items required.

Vot 28000 – Maintenance and Minor Repair Services

To document expenses for external services to ensure all facilities and assets are in good working
condition. This includes cleaning and painting services. Please note that this is allowable only for
equipment purchased under the same grant.

Vot 29000 – Professional Services, Other Services & Hospitality

To document all services and hospitality rendered including professional services, photocopying,
printing, wages, allowance or other payments to those not appointed as project staff, hospitality
and honorarium to invited collaborators. Honorarium is restricted to respondents, e.g., payment
for blood samples in a medical project.

Note:
Please provide details of services or hospitality rendered, inclusive of the rates and mode of
calculations.

Graduate Research Fund Application Form, Universiti Sains Malaysia 6

 PAPER PRESENTATION

FOR PAPER PRESENTATION ONLY

(Please provide evidence of acceptance of oral presentation and full paper)
1. Name of Conference: ………………………………………………..

2. Venue of Conference ………………………………………………..

(City, Country):
3. Duration: ………………………………………………..
4. Organiser: ………………………………………………..
5. Title of Paper : ……………………………………………………………………………..
……………………………………………………………………………….
……………………………………………………………………………….
……………………………………………………………………………….

6. Budget
(Please indicate estimated budget paper presentation)

* Transportation Cost

Registration Fees

Total Amount

* Only on Air Asia where available

Graduate Research Fund Application Form, Universiti Sains Malaysia 7

 RESEARCH ATTACHMENT

FOR RESEARCH ATTACHMENT ONLY

(Please provide evidence of acceptance of research attachment)
1. Name of Supervisor : ………………………………………………..

2. Venue of Research ………………………………………………..

Attachment (City,
Country):
3. Duration (Date and ………………………………………………..
Period) :
4. Justification of Research Attachment :
i. Objectives:

ii. Expected outcomes:

iii. Importance and benefits:

(Explain how your research attachment contributes of technology transfer or
advancement of new knowledge)

iv. Gantt-chart for research attachment:

* Please attach additional information if necessary/ available

5. Budget
(Please indicate estimated budget for research attachment)
* Transportation Cost

Food Allowance

Lodging/ Hotel Allowance

Bench Fees

• Only Air Asia where available.

Graduate Research Fund Application Form, Universiti Sains Malaysia 8

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

2. School/Centre:-

3. Candidate’s Name:-

4. Candidate’s Research Area:-

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

6. Please State:-

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

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

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

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

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

………………………………………………………………………………………………………
b. Potentials of the research area:

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

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

……………………………………………………………………………………………………..

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

……………………………………………………………………………………………………….
c. Supervisor’s Endorsement:

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

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

Date:………………….

Signature:………………………………………..

Graduate Research Fund Application Form, Universiti Sains Malaysia 9

F. DEAN’S ENDORSEMENT

Comment:

______________________________________________________________________

______________________________________________________________________

Signature : Official Stamp :

Name :

Date :

G. FOR OFFICE USE

The
Graduate Fund and Scholarship Management Committee endorsed the following
decision on …………………………………..

Results Comments

Accept

KIV

Reject

Graduate Research Fund Application Form, Universiti Sains Malaysia 10