Professional Documents
Culture Documents
Application Form For The Islamic University of Madinah, KSA.
Application Form For The Islamic University of Madinah, KSA.
No
Number of
Children
Marital Status
Married
Issue Place
City
Single
Issue Date
Province / State
Major
Stage /
Certificate
Completion
Date
Date of Birth
Original Nationality
Current Nationality
ID Card or Passport #
Country
About Residence & Place of Birth
Place of Birth
Present Place of Residence
Familys Place of Residence
Admit ion
Date
Duration of
Study
Governmental
or Private
Location
Personal Information
First Name
School Name
1
2
3
4
Fathers
Name
Applicants Quadruple Name
As Per Documents
In Arabic
In English (Block Letters)
Is your name given in your passport the same as it is in your educational documents ?
If not, please state the difference ::
Grandfathers
Name
Surname
5
6
8
9
10
Source
Grade
Level
..
Type
Private
Governmental
Percentage: :
Total Marks
Last Acquired Certificate
When Awarded
Major :
..
..
. :
Note : If private School is not Under Government Supervision, Please State Supervising Authority.
Educational Information
Faculty of Sharia
Intermediate
secondary
In Arabic
Pre-University Stage
Phone #
..
Fax #
..
Phone #
..
Fax #
..
.
In English (Block Letters)
.
In Arabic
.
In English (Block Letters)
.
,
. .
I hereby testify and confirm that all the foregoing information is true and correct. Also that all attached documents are
authentic and free from distortion and forgery. I further undertake to abide by the rules and regulation of the Islamic
University if I am accepted in case of any violation. The University has the right to take any action it deems fit.
Date :
Signature :
..
Applicants Name :
General Information
Applicant Choice
Address
:
University Stage : An applicant is requested to arrange the following faculties according to priority ?
Islamic University ?
Have you Applied for Admission to Admission to the Islamic
any other Saudi University ?
University
Before ?
No ) (
Yes ) (
No ) (
Yes ) (
No ) (
Yes ) (
.. :
Specify the country that has a Saudi Embassy Where you wish to apply for entry visa to the kingdom in case you are
accepted :
Undertaking