Save Memo name :
User Name :

Information related to International Cooperation at KMUTT
Quarterly Report :

Name of Faculty /School / Department of KMUTT :
Name of the coordinator :
Direction of Coorperation :           Inbound          Outbound
Participation in the Cooperation :   student          faculty          staff
Is this program under the MoU/Agreement :       No          Yes
Type of Exchange Program :       semester exchange (3-4 months)          short term (<=2 months)
                                               visiting faculty       staff training          internship
                                               symposium            research
Please mention, if othres :
Scholarship grants, if any :       Yes          No
Name and source of Scholarship/ Grant :
Additional grant from KMUTT, if any :
Mention the andme and amount of grant :
No. of students/ staff/ faculties participated :
Name of the Partner Institution :
Name of the Partner Country:
Faculty/ School to which the program took place :
Brief description of all activities that took place through this Program :
(Please attach documents , if relevant) :
Duration of activities :
Program Period (mention start and end dates) :
Date and Duration of extension of Program (if applicable):
Admission charges applicable? :       Yes          No
if yes mention the amount :
Accommodation provided is :           free of cost          chargeable
Accommodation Type :                    campus              outside campus
Enclosures (if relevant) :
Remarks (if any) :
Note: Please attach supporting/ agreements of relevance that needs to be considered and send the
filled up questionnaire to the following e-mail ids: