Initital Admission Application


Initial Admission Form
		نسخة العربية
	Degree	Bachelor
	Type of Study	Regular
	Personal Information
	Full Name (as recorded on the I.D. card*
	Civil Reg. No. or Residence No.*
	Nationality *
	Gender*	Male Female
	Marital Status*	Married Single
	Specialization
	Work*	Employed Unemployed
	Employer
	Work Place
	Work Phone
	Contact Information
	Mobile No.
	Parent / Contact Person' Number

	Academic Details
	Qualification	Secondary / High School Secondary Equation Diploma Bachelors
	Major
	Name of Previous School /College / University
	Graduation Date
	G.P.A	Excellent Very Good Good Pass
	Cumulative average
	General Aptitude
	Achievement test score / University Achievement Test Score:
	Occupational classification of the Health Specializations Authority for the health:	Exist Does not Exist
	English test (TOEFL - IELTS - STEP) for health diploma holders:	Exist Does not Exist
	Chosen majors "desires"
	Specialization

	Do you play any activity sport or hobby?	Yes No
	Note: This form is a request for initial acceptance of contact in the event that the conditions for registration apply and are not final acceptance

	I, the male / female student, certify that all the information provided above is correct and bear all responsibility if it becomes clear otherwise.
	Name:
	Signature with Date
		Admission and Registration Stamp
	Admission and Registration Officer::
	Name:
	Signature
	Date