20___ / 20___ SESSION
APPLICATION FORM
(for foreign applicants)
FUTURE EDUCATION
Proposed Degree program: Bachelor’s Master’s Ph.D/PG
Specialty / Field of study:
Country:
Chosen University:
1st alternative:
2nd alternative:
Want to study in medium of instruction: English Local language
PERSONAL DATA
Surname: Name:
Middle name: Gender: Male Female
Date of Birth: Place of Birth:
Nationality: National passport №: Date of Expire:
Country of visa application:
Permanent Address:
Contact Number: Contact E-mail:
EDUCATIONAL BACKGROUND
SCHOOL
School name: School address:
Attended Since: till Received Certificate:
COLLEGE / UNIVERSITY
College / University (if Attended) name:
College / University address:
Attended Since: till Received Certificate:
1. Copy of passport
APPENDIX 2. Copies of educational certificates
I confirm that the information given in the form is correct.
Date: ___ / ________ / ______ Applicant’s signature: ________________