UTM Student Academic Visit Online Application Form Application for Academic Visit to UTM A. Applicant Details University Name * Country Name of officer in charge (International Office) * This should be the contact from the International Office in your university. International Office Contact Number * International Office Email Address * Name of the Group Leader * Group Leader Contact Number * Group Leader Email Address * Programme date from * To * Host Faculty * B. Program Background / Objectives This form can be filled up as a group. Programme Background * Objectives * C. Participant List (All participant names must be listed) Name * Gender * Passport Num. * Year/Course * Email * Status (Staff/ Student) * Add Remove D. Activities List Date Activity * Details * Add Remove If you are human, leave this field blank.