View
28
Download
0
Category
Preview:
Citation preview
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
HD Helpdesk CS Counter Staff
NO. SEMAKAN : 02 NO. ISU : 02 TARIKH KUATKUASA : 20/04/2017 1 drp. 1
No. Required Documents (Please arrange the document according to the sequence given)
No of Copy
Tick (If Complete) Office Use
Applicant HD CS 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 of the passport)
*Please write number on each of the pages 2
4 ORIGINAL offer letter from UPM 1 5 Original Offer Letter from Home University/Company.
The following information should be mentioned on the Offer Letter: • Period of Programme (Start & End) • Place of Programme at Universiti Putra Malaysia
1
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
*Memorandum of Understanding (MoU) *Memorandum of Agreement (MoA) *Letter of Intent (LoI)
2
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
(MYR 270) 2
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.
Checked by
Date
SOKONGANPENGURUSANPELAJARDANSTAFANTARABANGSA
PUTRAINTERNATIONALCENTRE
(PUSATANTARABANGSA)KodDokumen:SOK/INT/BR01/VPVISA&PASSAPPLICATIONFORM
NO.SEMAKAN : 00 NO.ISU : 01 TARIKHKUATKUASA : 24/3/2017 1drp.2
TYPEOFAPPLICATION
PLEASETICK(/)NEWSTUDENT STUDENTRENEWAL
SPECIALPASS INVITATION/RELEASE/CLAIM
LETTER
VAL DEPENDENTRENEWAL TRANSFERSTICKER CANCELLATION/SHORTENING
NEWDEPENDENT IKHTISAS/RESEARCHATTACHMENT
STAFF STAFFDEPENDENT
STUDENT’S/STAFF’SPARTICULARS:1.NAME
:
_______________________________________________________________________
2.MATRIC/STAFFNO
:
_________________
GENDER
:
Male
Female
3.NATIONALITY4.PROGRAMME(ForStudentOnly)
:
BachelorMasterPhD
5.PASSPORTNO.
:
________________________________
7.PASSEXPIRYDATE
:
(DD/MM/YYYY)(DD/MM/YYYY)
8.MOBILENO.
:
________________________
9.EMAIL
:
________________________
10.NEARESTMALAYSIAEMBASSY:____________________________________________________(ForVALapplicationonly)
6.EXPIRYDATE:
: _____________________
NO.SEMAKAN : 00 NO.ISU : 01 TARIKHKUATKUASA : 24/3/2017 2drp.2
DEPENDENT’SPARTICULARS:
NAME PASSPORTNO.PASSPORT
EXPIRYDATESOCIALPASSEXPIRYDATE RELATION
IcertifythatallinformationgiveninthisapplicationistrueandIhavealsosubmittedapplicationformeormydependents:student/workingpass/visitpass(New/Renewal/SpecialPass/Shortening/Endorsement)
..……..……………………………... ………..……………………….. Student/Staff’sSignature Date……………………………………………………………………………………………………………………………………………………………………………………FOROFFICEUSEONLYPAYMENTCHECKLIST:(Note:PleasepresenttheoriginalreceiptfromtheBursarCounterandthecopyoftheReceiptuponsubmissionofyourapplicationtotheCounterofVisa&Pass.)
TYPEOFPAYMENT Student/Staff
Dependent1
Dependent2
Dependent3
Dependent4
Dependent5
Dependent6
NEWAPPLICATION:……………………………………
RENEWAL
SPECIALPASS
TRANSFERSTICKER
SHORTENING/CANCELLATION
INVITATIONLETTER/RELEASELETTER/CLAIMLETTER
LATESUBMISSION
OTHERS:……………………………………
TOTALAMOUNT(RM):
………………………………………… ……………………………………Officer’sSignatureandStamp DatePUTRAINTERNATIONALCENTRE
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.
Im. 38 - Pin 1/93
PERMOHONAN UNTUK VISANo. F 047643
Borang ini dikenakan bayaran sebanyak RM1.00
Visa No. ...............................
Nama Penuh............................................................................................................................................................
Nama dalam Tulisan Cina(Jika berkenaan - SILA TULIS DENGAN TERANG)
Tarikh Lahir...................................................Negeri Lahir......................................................................................
Loghat............................................................Kerakyatan.......................................................................................
Pekerjaan.................................................................................................................................................................
Alamat di Malaysia..................................................................................................................................................
Alamat di luar negeri...............................................................................................................................................
Pasport No. .............................................................................................................................................................
Kad Pengenalan No. ...............................................................................................................................................
Visa dikehendaki bagi negeri..................................................................................................................................
.................................................................................................................................................................................
Tarikh........................... ............................................
Jantina....................................
Tandatangan Pemohon
(Tempat dikeluarkan) (Tarikh dikeluarkan)
(Tempat dikeluarkan) (Tarikh dikeluarkan)
(Dengan huruf cerai)
(Masukkan nama Kerajaan yang mengeluarkan)
(UNTUK KEGUNAAN PEJABAT)
(Konsol Visa/..................).........................................................................................................................................
(Tarikh Saringan Akhir...........................).................................................................................................................
.................................................................................................................................................................................
.................................................................................................................................................................................
.................................................................................................................................................................................
.................................................................................................................................................................................
.................................................................................................................................................................................
.................................................................................................................................................................................
.................................................................................................................................................................................
.................................................................................................................................................................................
.................................................................................................................................................................................
.................................................................................................................................................................................
.................................................................................................................................................................................
[Borang ini diterjemahkan oleh Peguan Negara, Malaysia menurut Pemberitahu Undangan No. 12 tahun 1964, P.N. 3630/5-1 ; IMM1C197166 (12).]
JD125115 - PNMB..K.L.
JABATAN IMIGRESEN MALAYSIABORANG PERMOHONAN PAS LAWATAN
VISIT PASS APPLICATION FORM PERATURAN-PERATURAN IMIGRESEN, 1963 [Peraturan 11(12) dan 11(15)]
*Jenis Pas Type of Pass *Jenis Permohonan Type of Application
Iktisas Professional
Sosial Social
Berniaga Business
Kerja Sementara Temporary Employment
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 PERJALANANPARTICULARS OF PASSPORT / TRAVEL DOCUMENT
6. Jenis Dokumen Perjalanan Type of Travel Document
7. Nombor Number
8. Tempat / Negara Dikeluarkan Place / Country of Issue 9. **Sah Sehingga
Valid Until hari bulan tahunday month year
C. MAKLUMAT PENGANJUR DI MALAYSIA PARTICULARS OF SPONSOR IN MALAYSIA
IM. 12 – Pin. 1/97
10. Nama Penuh (Huruf Besar) Full Name (Capital Letter) 11. No. Kad Pengenalan NRIC
12. No. Telefon Telephone No.
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
Sekali Perjalanan Single Entry
Berulangkali Perjalanan Multiple Entry
Tarikh Date Tandatangan Pemohon / Penganjur
Signature of Applicant / Sponsor
• Borang ini hendaklah ditaip. Tandakan (x) dalam petak yang berkenaan. This form should be typed. Mark (x) in the appropriate box.
** 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
59-60/60
29-30/60 19-20/60
5-6/60
3-4/60
59-60/60
5-6/60
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.
Recommended