This signed form should be retained student
Student to complete:
Student Name eg: My NAME
Phone
(home) eg: 10987654
Student No. Phone
(work)
C10061, use pull down menu
Course
C10061
Phone
(mobile) civil, use pull down menu eg: 9876 5432 eg: 9876 5432 eg: 0400 123 456 eg: My.Name@student.uts.edu.au
Major civil
Email eg. Hung Nguyen eg. Engineering, IT, Science
UTS:Supervisor
Supervisor’s
Faculty use pull down menu Autumn 2010
Subject No.
48016
The semester in which you will enrol in this project
Spring 2011
What is the title of your project:
Your supervisor may want to review a brief outline or the project, using appropriate technical language by identifying what contributions your project can make to the engineering community in terms of scholarship, novel design, validation and verification of a method or model.
Provide name and contact details for external or co-supervisors for your project:
(Note: not your UTS supervisor – their name is entered over …)
If you are undertaking your project in a group, list the names of other group members here:
(Please use this format: Paul NGUYEN Duy NG Anthony SMITH)
Continued over … supervisor signature required on this form
CHECKLIST: Student to complete (* compulsory – must be completed):

* Supervisor’s signature on this form

* Student’s signature on the declaration on this form

Other :
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Please tick one or more of the following to describe the project you are undertaking;
The project topic was available from a list provided by my supervisor
The project topic was my own idea, and developed further through discussions with my supervisor
The project topic is my own, and I have secured a supervisor who is interested in what I am doing
The project topic was developed at my current, or previous place of work
The project will be undertaken away from UTS and not require UTS support or resources (other than supervisor)
T his project may require an Intellectual Property Agreement or Confidentiality Agreement
T his project may require me to visit external workplaces where I am not covered by my employers insurance
I understand that I am responsible for my capstone project and all activities associated with it. I undertake to adhere to the subject requirements, and student responsibilities and expectations as identified in the Capstone Project
Subject Guide and on Capstone Project Web site. I will undertake all activities related to my project on my own, and will acknowledge all information sources and all assistance received.
I understand that completing this Registration form, or the on-line Registration form, that this does NOT enrol me in a capstone project subject. I understand it is my responsibility to enrol correctly via the required UTS procedures into the correct capstone project subject by the nominated deadlines.
I will follow risk assessment procedures to identify and reduce all risks. I will discuss the Faculty’s Environment,
Health and Safety (EHS) policy with respect to correct laboratory practice with my UTS supervisor and follow all directions. I will not perform or undertake any UTS laboratory work without the permission of my supervisor. I will ensure that all such work will only be undertaken in the presence of a UTS staff member, another Capstone Project student, or responsible person approved by my supervisor. I will obtain advice from my project supervisor as well as the Capstone Project subject coordinator before going to an external workplace where I may not be covered by my employers insurance.
Student to sign: … … .
Date:
I understand that by signing this I am agreeing to supervise this student capstone project and thereby agree to adhere to all Capstone Project subject guidelines and requirements.
Name Faculty Signature Date
Stay up to date by regularly checking the capstone project web pages for the latest information
Instructions for Appendix A
1. Once you have filled-in ALL the cells, print a copy of this document
2. Sign the printed copy, ask your Supervisor to sign it
3. Keep this signed document for your records, there is no requirement to submit it
4. Do NOT use the Adobe Reader 'Email submit' button/option
5. Do use Adobe Reader to "Save As"; change the filename to your Student Number eg. 10987654.pdf
6. Email this pdf file to capstone@eng.uts.edu.au
.
* Do NOT submit half completed forms
* Do NOT submit your signed Appendix A to the APO
* Do email updated versions if required - we'll process the latest version received
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