PERKHIDMATAN UTAMA PUTRA INTERNATIONAL (PUSAT ANTARABANGSA) UNIVERSITI PUTRA MALAYSIA 43400 UPM Serdang, Selangor, Malaysia Tel: 603-8946 6048 / 6198 E-mail: intl@upm.edu.my Kod Dokumen: SOK/PIC/SS10 CHECKLIST FOR IKHTISAS APPLICATION PLEASE USE CAPITAL LETTERS Name: Passport No: Expiry Date of passport: d d / m m / y y y y No. Required Documents (Please arrange the document according to the sequence given) No of Copy 1 Checklist for IKHTISAS Application (SOK/PIC/SS10) 1 2 Visa & Pass Application Form (UPM/PIC/BR01/APPLICATION FORM) 1 3 A4 sized COPY of passport (all pages including the empty pages) 2 *Please put numbering to the all copy of passport pages 4 ORIGINAL offer letter from UPM 1 5 Original Offer Letter from Home University/Company. 1 The following information should be mentioned on the Offer Letter: Period of Programme (start & end) Place of Programme at University Putra Malaysia 6 Photo (Standard passport & Blue Background) Size 3.5 cm x 5.0 cm 2 7 IM 38 form 1 8 IM 12 form 2 9 Curriculum Vitae (CV)/ Resume 2 10 Copy of Academic Transcript from Home University 1 11 Copy of MoU/ MoA/ LoI between home university & UPM 2 *Memorandum of Understanding (MoU) *Memorandum of Agreement (MoA) *Letter of Intent (LoI) 12 Payment of Bank Guarantee Letter MYR 200 (Only for student from China) 2 13 COPY of Full Schedule (for Internship/Research Attachment only) 2 14 Proof of Professional Pass Approval Letter application payment to UPM 2 (MYR 270) Note 1. Documents which DO NOT follow the specifications are deemed incomplete and shall be rejected 2. Pease DO NOT staple your documents and photo. 3. Use a paper clip instead. Tick (If Complete) Office Use Applicant HD CS Checked by Date HD CS Helpdesk Counter Staff NO. SEMAKAN : 02 NO. ISU : 02 TARIKH KUATKUASA : 20/03/2017 1 drp. 1
SOKONGAN PENGURUSAN PELAJAR DAN STAF ANTARABANGSA PUTRA INTERNATIONAL CENTRE (PUSAT ANTARABANGSA) Kod Dokumen: SOK/INT/BR01/VP VISA & PASS APPLICATION FORM TYPE OF APPLICATION PLEASE TICK (/) NEW STUDENT STUDENT RENEWAL SPECIAL PASS INVITATION/ RELEASE/ CLAIM LETTER VAL DEPENDENT RENEWAL TRANSFER STICKER CANCELLATION/ SHORTENING NEW DEPENDENT IKHTISAS/RESEARCH ATTACHMENT STAFF STAFF DEPENDENT STUDENT S/ STAFF S PARTICULARS: 1. NAME : 2. MATRIC/STAFF NO : GENDER : Male Female 3. NATIONALITY 4. PROGRAMME (For Student Only) : : Bachelor Master PhD 5. PASSPORT NO. : 6. EXPIRY DATE: (DD/MM/YYYY) 7. PASS EXPIRY DATE : (DD/MM/YYYY) 8. MOBILE NO. : 9. EMAIL : 10. NEAREST MALAYSIA EMBASSY : (For VAL application only) NO. SEMAKAN : 00 NO. ISU : 01 TARIKH KUAT KUASA : 24/3/2017 1 drp. 2
DEPENDENT S PARTICULARS: NAME PASSPORT NO. PASSPORT EXPIRY DATE SOCIAL PASS EXPIRY DATE RELATION I certify that all information given in this application is true and I have also submitted application for me or my dependents: student/working pass/visit pass (New/ Renewal/ Special Pass/ Shortening/ Endorsement)........... Student/ Staff s Signature Date FOR OFFICE USE ONLY PAYMENT CHECKLIST: (Note: Please present the original receipt from the Bursar Counter and the copy of the Receipt upon submission of your application to the Counter of Visa & Pass.) TYPE OF PAYMENT NEW APPLICATION: Student/ Staff 1 2 3 4 5 6 RENEWAL SPECIAL PASS TRANSFER STICKER SHORTENING / CANCELLATION INVITATION LETTER/ RELEASE LETTER/ CLAIM LETTER LATE SUBMISSION OTHERS: TOTAL AMOUNT (RM): Officer s Signature and Stamp PUTRA INTERNATIONAL CENTRE Date NO. SEMAKAN : 00 NO. ISU : 01 TARIKH KUAT KUASA : 24/3/2017 2 drp. 2
EMGS & UPM ACCOUNT DETAILS FOR FEE PAYMENT EMGS Account: Payment can be made through Maybank counter or online payment (CIMB Click/ Maybank2u). Name of Bank : Maybank Account No. : 514057662341 Account Name : Education Malaysia Global Services Recipient Reference : Matric No./ Passport No. Other Payment Details : Based on Type of Application (Renewal/Cancellation/Shortening/Special Pass etc.) UPM Account: Payment can be made through CIMB counter or online payment (CIMB Click/ Maybank2u). Name of Bank : CIMB Account No. : 8002155042 Account Name : UPM Collection Recipient Reference : Matric No./ Passport No. Other Payment Details : Processing Fee Note: *Please make sure you have made the payment before come to the counter. *Please make two copies of each receipt. *Please make sure the reference number of each receipt is clear.
PERMOHONAN UNTUK VISA Borang ini dikenakan bayaran sebanyak RM1.00 Im. 38 - Pin 1/93 No. F 047643 Visa No.... Nama Penuh... Nama dalam Tulisan Cina (Jika berkenaan - SILA TULIS DENGAN TERANG) Jantina... Tarikh Lahir...Negeri Lahir... Loghat...Kerakyatan... Pekerjaan... Alamat di Malaysia... Alamat di luar negeri... Pasport No.... (Masukkan nama Kerajaan yang mengeluarkan) (Dengan huruf cerai) (Tempat dikeluarkan) Kad Pengenalan No.... (Tempat dikeluarkan) (Tarikh dikeluarkan) (Tarikh dikeluarkan) Visa dikehendaki bagi negeri... Tarikh...... (UNTUK KEGUNAAN PEJABAT) Tandatangan Pemohon (Konsol Visa/...)... (Tarikh Saringan Akhir...)... [Borang ini diterjemahkan oleh Peguan Negara, Malaysia menurut Pemberitahu Undangan No. 12 tahun 1964, P.N. 3630/5-1 ; IMM1 C197166 (12).] JD125115 - PNMB..K.L.
JABATAN IMIGRESEN MALAYSIA BORANG PERMOHONAN PAS LAWATAN VISIT PASS APPLICATION FORM PERATURAN-PERATURAN IMIGRESEN, 1963 [Peraturan 11(12) dan 11(15)] IM. 12 Pin. 1/97 *Jenis Pas Type of Pass Iktisas Professional Sosial Social Berniaga Business Kerja Sementara Temporary Employment *Jenis Permohonan Type of Application Baru New Lanjutan Extension A. MAKLUMAT PEMOHON PARTICULARS OF APPLICANT 1. Nama Penuh (Huruf Besar) Full Name (Capital Letter) Gambar Pemohon Photograph Of Applicant (3.5 cm 5.0 cm) 2. *Jantina Gender Lelaki Male Perempuan Female 3. Tempat/Negara Lahir Place/Country of Birth 4. **Tarikh Lahir Date of Birth hari bulan tahun day month year 5. Warganegara Nationality B. MAKLUMAT PASPORT PERJALANAN / DOKUMEN PERJALANAN PARTICULARS OF PASSPORT / TRAVEL DOCUMENT 6. Jenis Dokumen Perjalanan Type of Travel Document 7. Nombor Number 8. Tempat / Negara Dikeluarkan Place / Country of Issue C. MAKLUMAT PENGANJUR DI MALAYSIA PARTICULARS OF SPONSOR IN MALAYSIA 10. Nama Penuh (Huruf Besar) Full Name (Capital Letter) 11. No. Kad Pengenalan NRIC 9. **Sah Sehingga Valid Until 12. No. Telefon Telephone No. hari bulan tahun day month year 13. Alamat Address Negeri State D. KEPERLUAN VISA VISA REQUIREMENT 14. *Adakah Visa Diperlukan Visa Requirement Ya Yes Tidak No 15. *Jenis Visa Type of Visa Tarikh Date Sekali Perjalanan Single Entry Borang ini hendaklah ditaip. Tandakan (x) dalam petak yang berkenaan. This form should be typed. Mark (x) in the appropriate box. Berulangkali Perjalanan Multiple Entry Tandatangan Pemohon / Penganjur Signature of Applicant / Sponsor ** Format Tarikh 99/99/9999 Date Format DD/MM/YYYY
PLEASE NUMBER ALL THE COPIES TO AVOID MISSING PAGES AND DELAY AT EMGS For Example: If Your Passport has 60 pages, then on each page of your photocopy write the page numbers per total pages, 1-2/60, 3-4/60 59-60/60 If Your Passport has 40 pages, then on each page of your photocopy write the page numbers per total pages, 1-2/40, 3-4/40 39-40/40 1-2/60 3-4/60 5-6/60 19-20/60 29-30/60 59-60/60
EMGS & UPM ACCOUNT DETAILS FOR FEE PAYMENT EMGS Account: Payment can be made through Maybank counter or online payment (CIMB Click/ Maybank2u). Name of Bank : Maybank Account No. : 514057662341 Account Name : Education Malaysia Global Services Recipient Reference : Matric No./ Passport No. Other Payment Details : Based on Type of Application (Renewal/Cancellation/Shortening/Special Pass etc.) UPM Account: Payment can be made through CIMB counter or online payment (CIMB Click/ Maybank2u). Name of Bank : CIMB Account No. : 8002155042 Account Name : UPM Collection Recipient Reference : Matric No./ Passport No. Other Payment Details : Processing Fee Note: *Please make sure you have made the payment before come to the counter. *Please make two copies of each receipt. *Please make sure the reference number of each receipt is clear.
EXAMPLE NAME PASSPORT NUMBER
EXAMPLE PASSPORT NO TYPE OF APPLICATION