Website Request Form Please fill in the form that will help us to assess your request. If you are unsure of any of the answers, just say so and we will contact you to clarify. Applications must be submitted 7 days before the date required. If you are human, leave this field blank. Applicant Name * Job Title * Unit, Department or Faculty * Email * Office Number * Mobile Number * Website Details Your Website Title * Example: Office of Corporate Affairs 1. Proposed Website Address * Example: http://www.utm.my/yoursite 2. Expected date for the site to be completely develop? * 3. What is the main purpose of the site (e.g. to promote research or recruit students) and what key messages are you trying to convey? * 4. Who is your site aimed at? Student Staff Faculty Alumni Community 5. Will there be any information on the site that would not be available publicly? Please specify and give reasons. * 6. Who will be the administrator for the site? (please specify name) 7. Admin email address (prefer @utm.my) * 8. Is there any other information that you think we might need to know? 9. Website visibility * Internet Intranet Checkboxes * I agree to the UTM web policy and guideline Checkboxes Option 1 Option 2 Website/URL Email Radio Buttons Option 1 Option 2
