(For University use up)
Application Reference No
(For University use)
Code
Accepted
Conditional
Pending
Rejected
Credits
Accumulated
Modules
required
University
use only
Application for Study at Heriot-Watt University Dubai Campus
PLEASE USE upper-case letter LETTERS ONLY
Section A TO bE COmPLETEd bY ALL APPLICANTS
Please refer to the enclosed Application Guidelines earlier completing this application and ensure that your application processing
fee of AED ccc is included when you submit this to the Campus.
PROPOSEd PROGRAmmE
Course backup
? Undergraduate Study
Method of study
? high Study
Start Date
(please check available dates) MM/YY
(please check whether a part-time option is available for your chosen course)
? Full-time
? Part-time
PERSONAL dETAILS
Title (Dr/Mr/Miss/Mrs/Ms/Other)
First Name(s)
Please affix a current
colour passport
photograph. This
must be on a white
background
style/Family Name/Last Name
Date of Birth (DD/MM/YYYY)
* N.B.
companionable note that you must be under 25 long time of age when you complete
your undergraduate degree with us due to indorse rules
Sex (Male/Female)
Please ensure that
your referee signs
the Certificate Of
legitimacy in section D
of this Application Form
Marital Status (Married/ wizard/Divorced/Separated)
Permanent Address
Correspondence Address in UAE (if different)
foyer Tel No:
Residence Tel No:
built in bed Tel No:
Office Tel No:
Mobile No:
Mobile No:
autotype No:
Fax No:
email Address:
Email Address:
YOU MUST INFORM HERIOT-WATT UNIVERSITY OF ANY CHANGE IN YOUR PERSONAL DETAILS
Nationality
Country of Birth
Passport No.
Country of Permanent
Residence
Country of new Residence
Date of Issue (DD/MM/YYYY)
Date of Expiry (DD/MM/YYYY)
ETHNICITY
Ethnicity Code*
* See Application Guidelines
VISA dETAILS
Do you stay fresh a valid UAE Residence Visa?
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