Application Form

Emails: star_consultants_ukraine@yahoo.com, star.educonsult@gmail.com, info@edu-ukraine.com Website: www.edu-ukraine.com, Tel: +380 67 8963521, +380 937576143 Name and contact information PERSONAL DETAILS
NAME: Your legal name Fill APPLICATION form in CAPITAL words i.e. clear, visible, understandable

Family (last) name Place of birth

First name Nationality by birth

Male

Female Day

Middle name Month Year

Sex Current Nationality Program you want to join Current Qualification University in Ukraine you prefer to join Intl Passport No.
Passport Issue & Expiry Date

Date of birth
Place of issue of Ukraine visa

I do not have Intl passport, since I do want to secure my admission & Ill forward the Intl Pass. later once its ready

Higher Secondary School Cert.Bachelor Master Ph.D.

Degree sought VALID POSTAL ADDRESS & CONTACT NUMBERS(Invitation letter will be forwarded later to this address) Street number and street name Province or State Tel. No.: Fax Country Code Applicant's Signature: Area Code Local number Date: Zip or Postal Code & Country City/Suburb Email address

Specialist Other ________________ BachelorSpecialist Master Ph.D.

I justify that information given above is complete and accurate.

___________
Applicant's Signature

Scan Application form with following documents

All available Educational Certificates/ Diplomas/ Transcripts (O level/Senior School Certificate Examination/ Higher Secondary School Certificate Examination/ Bachelor/ Master Degree if available) International Passport scans (Data page with Photograph, Name and Serial number) Forward all scans to: star_consultants_ukraine@yahoo.com, star.educonsult@gmail.com, info@edu-ukraine.com

Your current Picture