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Monday 25 February 2013

Transction Piece Theory

REGISTRATION/MATRICULATION NO:
(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)

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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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