perkhidmatan utama putra international (pusat … · 2020. 3. 14. · putra international (pusat...
TRANSCRIPT
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NO. SEMAKAN : 02 NO. ISU : 02 TARIKH KUATKUASA : 20/04/2017 1 drp. 1
PLEASE USE CAPITAL LETTERS
Name:
Passport
No:
Expiry Date
of passport: d
d
/
m
m / y y y y
PERKHIDMATAN UTAMA
PUTRA INTERNATIONAL (PUSAT ANTARABANGSA)
UNIVERSITI PUTRA MALAYSIA
43400 UPM Serdang, Selangor, Malaysia Tel: 603-8946 6048 / 6198 E-mail: [email protected]
Kod Dokumen: SOK/PIC/SS11
CHECKLIST FOR INVITATION / RELEASE LETTER
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 Invitation / Release Letter (SOK/PIC/SS11) 1
2 Visa & Pass Application Form (UPM/PIC/BR01/APPLICATION FORM) 1
3 A4 sized COPY Student passport (Details & Pass page) 2
4 A4 sized COPY Dependent passport (Details & Pass page) 2
5 COPY Receipt of Payment to UPM (RM110.00)
Checked by
Date
HD Helpdesk
CS Counter Staff
mailto:[email protected]
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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:
: _____________________
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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
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