Student Pass Extension Form (Guide)

Guide to fill

(Fill in Block Letters)

  1. Your Full Name
  2. (Ignore)
  3. Female/Male
  4. Date of Birth
  5. Place/State of Birth (ex: Sabah, Kuala Lumpur, Selangor)
  6. Your I.C no.
  7. Your hometown address
  8. Particulars of Travel Document Held:
    1. Circle Ordinary Passport
    2. Your Passport No.
    3. Your Passport expiry date
    4. Malaysia
    5. Malaysian
  9. If Visa granted before arrical state:
    1. Your student pass reference no. (search for “Ref. No”) at student pass detail
    2. Miri
    3. Your student pass date of issue
  10. Latest date you enter Miri
  11. Circle (how you enter Miri) “Kapal Terbang” or “Jalan Raya”
  12. Your student Pass expiry date
  13. 6 months/I year/2 years/3years (Depend on your duration of study and your passport validity)
  14. “Still studying in Curtin Malaysia”
  15. Date you submitted the form to the student pass office
  16. Your signature

Student Pass Reference Sample


Student Pass Extension Form Sample

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