APPLICATION FORM FOR PERMANENT RESIDENCY IN MALAYSIA
TO BE FILLED BY THE APPLICANT

Write in CAPITAL LETTERS ONLY
1. Applicant’s Name :………………………………………………………………..................................
………………………………………………………………………………………………………………………
2. Kulliyyah / Centre / Institute :………………………………………………………………..................
3. Position :………………………………………………………………...............................................
4. Grade :………………………………………………………………..................................................
5. Date of Birth (…………../………………/…………….)
Date / Month / Year
6. Sex : Male / Female
7. Nationality :………………………………………………………………...
8. Passport No :………………………………………………………………...
9. Current Mailing Address) :………………………………………………………………......................
………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………
10. Office Telephone No :.........................................................................................
11. Mobile Phone No. :…………………………………………………………..
12. Email Address :………………………………………………………………...
13. Please fill in the points according to the Point Description in Appendix A
Criteria
A
Marks
Please enclose certified
photocopies of the following
documents in order with the
application form.
Please mark (√) if enclosed
Age
Passport Copy
B
Academic/
Professional
Qualification
Highest Qualification
Certificate
C
Language
Proficiency in
Bahasa Malaysia
D
E
F
Supporting Documents
(e.g. Letter from CELPAD)
Staying Period
Working Visa and other
Supporting Documents
Supervision
Supporting Documents
Research and
Consultancy
Number of projects
Supporting Documents
Amount of Research &
Consultancy
Supporting Documents
G
Publications
Supporting Documents
H
Employment
Supporting Documents
Total Marks :
13. Declaration :
I hereby declare that the above information is correct to the best of my knowledge and if found
incorrect, my application form can be rejected at anytime by the International Islamic University
Malaysia.
Applicant’s signature : ……………………………………….
Name :…………………………………………….
Date : ………………………………………………
14. Verification from the Dean of Kulliyyah:
I verify that the above information is correct.
Dean’ s signature : ……………………………………….
Name :…………………………………………….
Date : ………………………………………………
APPENDIX A
Criteria
Description
Points
A

18 – 35
5

36 - 65
10

PhD

Age
B
Academic/
Professional
Qualification
Critical Field *
20
Non-critical
15
Master Degree
15
10

Professional/Specialist
15
10

University Degree
10
5
(Take whichever is higher)
C
Language
Proficiency

Bahasa Malaysia
10
D
Staying
Period **



More than 10 years
6 – 9 years
3 – 5 years
10
5
3

More than 3 PhD or 9 Masters
10
E
Supervision
(Completed
Supervision
for the past 3
years)
F
Research
and
Consultancy
(Completed
project for
the past 3
years)
Amount of
RM for
Research
and
Consultancy
(Completed
project for
the past 3
years)
Clinical
Lead at least one (1)
registered with IIUM
research project (s) of at
least RM10K
Non-clinical
Lead at least one (1)
registered with IIUM
research project (s) of at
least RM20K
S&T
Lead at least one (1)
registered with IIUM
research project (s) of at
least RM20K
Arts
Lead at least one (1)
registered with IIUM
research project (s) of at
least RM10K
Clinical
At least RM50K
(cumulative)
Non-clinical
At least RM100K
(cumulative)
S&T
At least RM100K
(cumulative)
Arts
At least RM30K
(cumulative)
10
10
G
H
Publications
(for the past
3 years)
Employment
Clinical
Minimum 5 publications
At least 5 from publications
in citation indexed journal
(SCOPUS/ISI/SCI/SSCI/AI)
including refereed
proceedings and 2 as first
author
Non-clinical
Minimum 10 publications
At least 5 from
publications in citation
indexed journal
(SCOPUS/ISI/SCI/SSCI/AI)
including refereed
proceedings and 2 as
first author
S&T
Minimum 10 publications
At least 5 from publications
in citation indexed journal
(SCOPUS/ISI/SCI/SSCI/AI)
including refereed
proceedings and 2 as first
author
Arts
Minimum 10 publications
At least 3 from
publications in citation
indexed journal
(SCOPUS/ISI/SCI/SSCI/AI)
including refereed
proceedings and 2 as
first author

Total Points
Minimum Passing Points
Employment in accordance with professional
qualification
:
:
* Science and Technology field
** At Least 5 years working in IIUM
100 points
80 points
10
1 point for every 1 year of
working experience with a
maximum of 10 points