Thank your for your application. Your application will be processed. Notes : 1. Please make two (2) copies of this form. 2. The complete application form must be submitted in two (2) sets. Application Ref No 15020164528 (Please remember/keep this application reference number. You need this reference number for your application status query as well as to update your application information.) Name WAN MOHAMMAD HELMAN BIN WAN HUSSIN IC Number 801031035397 Level of Study PHD Name of Programme PT163-Islamic Economics (Economics) Mode of Study Research Research Title "ANALISIS INDEKS KEPRIHATINAN PENGGUNA (IKP) TERHADAP MASYARAKAT DARI PERSPEKTIF EKONOMI ISLAM" Proposed Supervisor Profesor Madya Dr. Mohd Yahya bin Mohd Hussin Dr. Fidlizan bin Muhammad Faculty Fakulti Pengurusan dan Ekonomi Please affix a recent photograph (COMPULSARY) Please make sure all the documents that are listed in the CHECK LIST for APPLICANT are enclosed : Application will not be processed by UPSI unless Reference ID and all the document that are listed in the CHECK LIST for APPLICANT are enclosed. All completed applications must be sent to: Admission Unit Institute of Graduate Studies Universiti Pendidikan Sultan Idris 35900 Tanjong Malim Perak Darul Ridzuan Malaysia Hotline :05-4505480/5482/5511/5494 Fax : 05-4594649 Page 1/2