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This document is an admission application form for a Ukrainian university. It requests personal information such as name, date of birth, nationality, passport details, contact information, and English proficiency. It also asks for academic details including schools attended, degrees earned, grades, and the intended course of study. Services like student visas, airport pickup, and accommodation can be requested. The applicant declares the information is correct and the university regulations will be observed if admitted. The form is then signed by the applicant and stamped by the Ukrainian university officials to acknowledge receipt.

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109 views3 pages

Fax To

This document is an admission application form for a Ukrainian university. It requests personal information such as name, date of birth, nationality, passport details, contact information, and English proficiency. It also asks for academic details including schools attended, degrees earned, grades, and the intended course of study. Services like student visas, airport pickup, and accommodation can be requested. The applicant declares the information is correct and the university regulations will be observed if admitted. The form is then signed by the applicant and stamped by the Ukrainian university officials to acknowledge receipt.

Uploaded by

snazzy
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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www.studyinukraine.

site
Email : this form to ……
:[email protected] OR
FAX TO +380-577204730

Passport Size Photo

UKRAINE EDUCATION ADVISORY SERVICE-UKRAINEEAS

ADMISSION APPLICATION FORM


2016
OFFER FOR 3ARD STUDENT OF 2 HURRY UP

PERSONAL DATA
Date of
Last Name First Sex
birth

Nationality Marital Status

Mother Tongue

Phone E-mail Address

Passport Number Date of Issue Date of Expiry

Place of Issue

Father / Guardian’s Contact Details :

Name and Surname

Address

Phone E-mail Address


English Language Proficiency Level : Medium Of Study :  English  Russian  Ukrainian

Written Spoken

Required Services :
NO
Student Visa YES NO Airport pick-up YES

Invitation Letter YES NO

Accommodation YES NO

ACADEMIC PARTICULARS
School Leaving Certificate :
School/College Address
Attended

Name of the University / Board Year of


Attended passing

Examination Passed - Higher Secondary / Equivalent exam :

School/College

Year of
Address
passing

Please indicate the required courses that you have completed (only for medical & engineering STUDENTS )
Credits Grade

Chemistry

Biology

Mathematics*

Physics*
*Required for SCIENCE STUDENT

Have you ever been dismissed from a college or placed on academic probation? YES NO

If so, please explain:

Any Higher Examination : FOR MASTER & PGD OR PHD STUDENT

 Master’s
Program of Study
Ph.D.

Name of the Address


University/College OR
SCHOOL
Year of
Name of the Course/Degree
passing

INDICATE COURSE YOU WANT TO STUDY :. _____________________________________________________

Score
Applicant’s Declaration:
I certify that the information given in this application is correct and complete.
If I am admitted to a University I undertake to observe the University regulations and to ensure Agency payments and tuition fees with
other financial liabilities to the University.
Applicant's Signature: ___________________________ Date: ____________________

OFFICE USE ONLY


Applicant's Signature: ___________________________ Date: ____________________

We hereby acknowledge receipt of the candidate’s application. The above-mentioned student is:

􀀀 provisionally accepted at our institutions


􀀀 not accepted at our institutions
UKRAINEDUCATION: Branch Coordinator’s Signature: ................................................
Date: ....................................

UKRAINEDUCATION: Headquarters Admission Officer’s Signature: .........................................

Date: ...........................

...................................................
Stamp

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