REPLY FORM

Note : This reply form is not valid if sent without the accompanying letter produced by the Universiti Tun Hussein Onn Malaysia

To
Head Office,
University And Industry Relations Office (PHI)
Universiti Tun Hussein Onn Malaysia (UTHM)
86400 Parit Raja,
Batu Pahat, Johor Darul Takzim Malaysia.
Tel : 607-4537193 / 7457 Fax: 607-4536262
Email : phi@uthm.edu.my

Sir/Madam,

Please see below the reply card in relation to the application for industrial training placement as requested by your office . Our
company ** AGREE / DO NOT AGREE to provide industrial training placement to your student starting from 01 Jul 2018

NAME OF STUDENT   : MUHAMAD HAZIM BIN ABDUL HALIM

IDENTIFICATION NO : 981002036439   MATRIX NO : AA161689
FACULTY            : CENTRE FOR DIPLOMA STUDIES
PROGRAMME         : DIPLOMA IN MECHANICAL ENGINEERING

NO. PARTICULARS YES NO

1 Accomodation is provided
2 Transport is provided
3 Meal is provided
4 Allowance is provided

If YES, please state the amount of allowance provided RM : ____________

Name of Officer : ______________________________ Post : ___________________________
Address :

PDE PARTNERSHIP SDN BHD Company Stamp:

PT 2498, SUITE 2, TINGKAT 2,
KOTA KENANGAN, KG CHERANG, JALAN HOSPITAL,
15200 KOTA BHARU KELANTAN

Telephone No  : ____________________________

Mobile Tel No : ____________________________
Fax No       : ____________________________
Email      : ____________________________

Confirmation of Acceptance Offer for Industrial Training Placement

I MUHAMAD HAZIM BIN ABDUL HALIM Matrix ID No AA161689 from the Faculty of CENTRE FOR DIPLOMA STUDIES
accept / do not accept the offer for industrial training placement as stated in the reply form above. **I do not accept this
offer because of _________________________( **for non-acceptance state your reason). Upon confirming my acceptance of
offer, this is to verify that I will not be changing my industrial training placement without valid and justifiable reason
which must be agreed by the company. I understand that any failure to report for duty in the company on the date
mentioned above could lead to my failure in this module.

Yours sincerely

_____________________
( MUHAMAD HAZIM BIN ABDUL HALIM )
** Please cross the necessary part