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A. APPLICATIONDETAILS REFERENCENO : 505754

Programmeof Study : PhD in ChemicalEngineeringby Research

Modeof Study : Full Time

AcademicYear : 2012 Intake : Sept

For Research ProgrammesOnly

Area of Specialization: ReactionEngineering

ProposedResearchTitle : Heat transferand kinetic studies in coal fired fluidizedbed reactor

ProposedSupervisor: AssociateProf Dr. Nurul Hasan

B. PERSONALDETAILS

Full Name: MuhammadZia-ul-haq

Gender : Male NRIC / Passport No : AC5907821

Dateof Birth : 19/12/1969 Place Of Birth : Faisalabad

Age : 42 years Marital Status : Married

Nationality: Pakistani Ethnicity : Asian Religion : Islam

Mailing Address: 26-A StreetNo. 1 RahmaniaRoad, Nazim Abad, Faisalabad, Pakistan.

Postcode : 38090 City : Faisalabad State / Province: Punjab Country: Pakistan

Tel No : 0092-323-7618944 Mobile N o : 0092-323-7618944 Email : ziaulhaqnfc@yahoo. com

PermanentAddress @HomeCountry(if different from Mailingaddress) :

Postcode : City : State / Province: Country:

C. QUALIFICATIONS

Please providedetails of degree obtained from University/ College/ Other Tertiary Institutions

AcademicQualificationObtained Result / Achievement(CGPAor equivalent)

Nameof Institution Period of study LanguageofInstructionFrom To

Matriculation 1st Div. B.I.S.E Sargodha 1984 1986 English

F.Sc. 1st Div. B.I.S.E Sargodha 1986 1988 English

B.Sc. Chemical Engineering 1st Div. U.E.T 1992 1997 English

M.Sc. Chemical Engineering 1st Div. NFC-IEFR 2008 2010 English

Other ProfessionalQualifications:

Research Experience:

Publication(providecitations):

D. LANGUAGEPROFICIENCY

Proficiencyin Malay language(For local applicantsonly)

Proficiencyin Malaylanguagein SPM/MCEGrade Year Passed

Proficiencyin English language(For all applicants)

Test Date Taken Grade/Point Obtained

1.

2.

3.

4.

E. WORKINGEXPERIENCE

Please providedetails of currentand previousemployment(start with the most recent)

PresentPosition: Assistant Professor Since : 02/07/2007

BusinessAddress : NFC-Instituteof engineeringand fertilizerresearchFaisalabad, Pakistan

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Postcode : 38090 Country: Pakistan

Tel No : +92-41-9220355 Fax No : +92-419220360 Email :

From To Positionand Nature of Work Employer

12/05/1998 26/10/1999 Lecturer NFC- Instituteof engineeringand fertilizerresearch

01/11/1999 31/05/2006 Plant Manager/PolymerProcess Plant Ed-CON-Faisalabad

F. FINANCIALSUPPORT

I am applyingfor UTP GraduateAssistantshipScheme(GA) -Research and Full-time only. If it is unsuccessful, I wish to study as a full-fee student No

G. REFEREES

Please providedetails of two refereeswho are able to commenton youracademiccapabilities.

Name Organization Tel. No. Email Address

1. Prof. Dr JavaidRabbani Khan DirectorNFC- Institute of engineeringand fertilizer research +92-41-9220355Ext 103drjrabbani@yahoo.com

2. Prof. Dr. ShahidRaza Malik HOD ChemicalEngineeringDept. NFC- Instituteof engineeringand fertilizer research+92-41-9220355 Ext 133 drsrma@yahoo.com

H. PERSONTOBE NOTIFIEDIN CASE OF EMERGENCY

Name : IhtashamulHaq Relationship: Brother

Address: 26-A StreetNo. 1 RahmaniaRoad, Nazim Abad, Faisalabad, Pakistan.

Postcode : City : Faisalabad State : punjab Country: Pakistan

Tel No : +923236685346 Fax No : Email :

I. DECLARATION

I hereby declare that I have personallyfilled in this ApplicationForm and that the informationcontainedherein is complete and accurate to the best of my knowledge. Iunderstandthat withholdingor giving false informationwill make me ineligiblefor admission and future enrollment. I further understandthat if at any time the informationor partthereofstated in this declarationis found contraryto facts, the Universityhas the authorityto disqualify, or if I am already admitted, to terminate my candidature.

Signatureof Applicant Date 08 May 2012

App licati on Check li st -

ApplicationForm signed

ResearchProposal ( Only for Researchmode)

Certified true copyof IC (Malaysian) or Certified true copyof passport(non-Malaysianif readilyavailable)

Certified true copy of academictranscript (Undergraduate& above)

Certified true copy of Degreescroll

TOEFL / IELTS / MUET certificateenclosed

4 copiesof passport-size photo

2 Refereeform

* Documentssubmittedmust be translatedin English (for non Englishand Malay languagedocuments)

This form is to be returned to the followingaddress;

Admission& RegistrationUnit

RegistryOffice

UniversitiTeknologiPETRONAS

Bandar Seri Iskandar

31750 Tronoh

Perak, Malaysia

(Attn: Tajul Ariffin Bin Shamsuddin)

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