International Student and Mobility Centre (Visa Unit)
Marketing and Academic Services Department
Universiti Malaya, Kuala Lumpur
[email protected] 03 7967 7857 /7858
SPECIAL PASS APPLICATION FOR STUDENT
UPDATED: DECEMBER 2024
AASC/UPPA/BR006/2021
STUDENT’S DETAILS (PLEASE WRITE IN CAPITAL LETTER)
Name of student (as shown in passport) :
Phone Number: Siswamail/ Email :
(Malaysian Phone Number)
Country: Passport Number:
Level of Study: Bachelor / Master / PhD Student ID Number:
Faculty: Programme:
Documents Checklist For office used
Latest entry date:
1. ORIGINAL PASSPORT ……………
Current pass validity:
……………
PASSPORT COPY ( 2 copies)
2.
a. Front page
b. Current visa/pass page
3. Format A Form - (Please get the form at the Counter)
REASON FOR APPLYING A SPECIAL PASS
( ) Completed/ Withdrawn/ Terminated from the study programme or change to the new study
programme
( ) Change from Student Pass to Other Passes (Must provide approval letter from Immigration)
( ) Pending Decision for Student Pass
( ) Making arrangement to Leave the Country (Check Out Memo)
4.
(The Flight Ticket to your Home Country must be provided within 21 working days from the application
date. Travelling to the third country is strictly prohibited by the Immigration act. A valid residence Pass is
required if travelling to the 3rd country).
( ) Overstay (Must state the reason) – Not more than 30 days
_________________________________________________________________________
_________________________________________________________________________
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Note: Please seek advice from our staff at the Counter before applying for the Special Pass.
Payment Receipt: RM50.00 for Visa Processing Fee. (Not refundable) Total amount paid:
5. (payable through UM EPAY at epay.um.edu.my)
……………
6. 2 COPIES OF eVISA - For new student/ new arrival
Proof of payment receipt to EMGS JOM PAY –
Special Pass Application Fee SPECIAL PASS FEES Total amount paid:
7.
CATEGORY FEES
(RM) ……………
1st Special Pass 154.00
2nd Special Pass 208.00
MFM/SP/4_24