FORM SGS S001

School of Graduate Studies

NOMINATION OF SUPERVISOR AND SUPERVISORY COMMITTEE

To be completed by student.
Please attach with an Intent of Research(about 1000 words) indicating the title /
area of study, brief statements of problem; research questions; conceptual
framework; and a short account of the methodology to be used in answering the
research problems.
PART A : STUDENT DETAILS
Full Name

Student ID No.

School :

Programme :
Field of Study

Proposal Title

PART B : NOMINATED SUPERVISOR DETAILS

Please include a full justification for the nomination of each supervisor,
addressing issues of expertise, relevance and independence*.
Please provide a list of recent or key publications for each nominated supervisors
(maximum 2 pages).
*The supervisor nominated herein should not be related or a close family

members to the student.

NOMINATION OF SUPERVISOR

Name of Supervisor

Correspondence Address:

Contact No.

Email Address
Justification

Office
:

Mobile

NOMINATION OF SUPERVISORY COMMITTEE (If required)

Name of Supervisor 1

Correspondence Address:

Contact No.

Office

Email Address
Justification

Mobile

:
:

Name of Supervisor 2

Correspondence Address:

Contact No.

Email Address
Justification

Office

Mobile

:
:

PART C : DECLARATION
Please tick in the appropriate box and sign.
I have consulted the nominated supervisors and they agree to the
nomination. OR
I have been consulted about the supervisors nominated by the Dean and
agree to the
nomination. OR
I have been consulted about the supervisors nominated by the Dean and
have reservations
about the nomination as detailed in the attached note
to the Dean of Graduate Studies.

Signature of Student & Date

Signature of Supervisor & Date

Signature of
Supervisory Committee & Date

Please send completed form to School of Graduate Studies, Asia e University, Level 17,
Main Block Dataran Kewangan Darul Takaful, Jalan Sultan Sulaiman, 50000 Kuala Lumpur