Application Registration
Application of Overseas Students Admission

Personal Identifications:
1- Last Name:

2- First Name:

3- Middle Name:

4- ID Number:

5- Date of Birth:       (Month, Day, Year)
6- Place of Birth:     City: County:
7- Nationality:  8- Religion:
9- Sex:   Male Female
10- Passport Number:
Date of Issue:     (Month, Day, Year)

11- Marital Status: Single    Married   

Number of Children:
12- Dependents Information: (Including Spouse and Children)

Last Name

First Name

Date and Place of Birth

Nationality

Relationship with Applicant

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 
13- Current Mailing address of applicant:
Zip code/Postal Code:
Home:
Office:
Tel:
Fax:
E-mail:

Educational Background:

 14- List all educational institutions attended after high school in chronological order.

Name of

School/University

Location

(Country)

Field

of Study

Date of Attendance

From

To

 

 

 

 

 

 

 

15- Are you currently studying at any institution?  Yes    No

If yes, please complete the table below.

  

Field of Study

Name and Address of Institution

Degree Sought

Starting Date

Graduation Date

(expected date of graduation)

 
16- Interested field of study:  
1- 2- 3-
7- For which level do you apply?  
Undergraduate M.Sc. Degree Ph.D. Degree
18- Please specify how you will be financially supported: 
Personal Income Scholarship (Indicate source of your scholarship)
19- Date you expect to start the program:
20- Do you have any physical disability?
Yes No If yes, please explain:
21- English and Persian Languages Skills:

LANGUAGE

READING

WRITING

SPEAKING

Excellent

Good

Fair

Poor

Excellent

Good

Fair

Poor

Excellent

Good

Fair

Poor

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 
 
22- Publications (books, articles ...)

Title

Year

Publisher

 

 

 

 

 

 

 

Professional Experience:

23- Details of Previous and present employment:

Present institutional affiliation

 

Previous

 

I fully understand that filling this questionnaire does not constitute any offer of admission to the University of Mazandaran, and I hereby certify that the information given above is all true and complete and, if admitted, as a student shall adhere to all academic and disciplinary measures of University of Mazandaran.

 
Applicant’s Name and Signature:                                Date: