PIP 2024 Registration Form

REGISTRATION FORM FOR
INTERNATIONAL LEARNING INNOVATION COMPETITION 2024
PERTANDINGAN INOVASI PEMBELAJARAN PERINGKAT ANTARABANGSA
(PIP2024)
DATE : 7 - 9 OCT 2024 | MU'ADZAM SHAH HALL, UUM
Project Leader Full Name*
Organization*
E-mail*
Tel no. /HP*
Project Title*
Project Synopsis*
IndividualGroup (1-5 including team leader )
Escort Teacher 1 (if any)
Escort Teacher 2 (if any)
Team Member 1
Team Member 2
Team Member 3
Team Member 4
Name of Team Members (if any)
Mailing Address*
Country
CATEGORY OF PARTICIPANT

(Please select one of the following categories)

Category	Institution	Malaysian (RM)	International (USD)
Category A	Open: Lecturers of IPT/IPTS, IPG, Community College, and School Teachers; Agencies, Industries	250	60
Category B	Open: Students of IPT, IPG, Polytechnic, Community College	200	50
Category C	Student: High School and Matriculation	130	35
Category D	Student: Primary School	80	20
Category E	Student: Disabled & Special Needs	80	20
Category F	IAP UUM (Inspirational Academician Program)	100	25

Category A: Lecturers of IPT/IPTS, IPG, Community College, and School Teachers; Agencies, IndustriesCategory B: Students of IPT/IPTS, IPG, Community College, Polytechnic
Category C: High School and MatriculationCategory D: Primary SchoolCategory E: Disabled & Special Needs (Students of IPT/IPTS, IPG, Community College, Polytechnic,High School, Matriculation & Primary School )
Category F: IAP UUM (Inspirational Academician Program)
TRL Level (If Applicable)
METHODS OF PAYMENT

Note: Please do the payment after you get acceptance notification email
Online Banking / Electronic Fund Transfer (EFT)VOT Transfer (For UUM Only) - Please provide VOT NumberGovernment Order (LO)Telegraph Transfer (Outside Malaysia Only)
VOT No.*
Please enter VOT. No
Signature

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Date
Secretariat:
Pusat Pengajaran dan Pembelajaran Universiti (UTLC)
Universiti Utara Malaysia, 06010 UUM Sintok, Kedah
Tel: 04-928 4697/4707/4705/4710/4713 Fax : 04-928 4702
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