Payment for MOBILITY FEES

Please enter information on this form to make payment for MOBILITY FEES.

Name *

Phone Num *

Email *

Passport Number *

Home University *

Type of Fees *

Total

MYR

Payment method

Online Payment ( FPX / Credit Card/ Debit Card )

Billing Zipcode*

Credit Card Number*

Expiration Date*

Card (CVV) Code*

Card Type*

Card Holder Name*