1. PERSONAL INFORMATION
Family name:
Middle name(s)
Given name
Gender
MaleFemale
Date of birth (dd/mm/yyyy)
CONTACT INFORMATION
Passport No. / ID card No.(if any)
Expiry date of Passport (dd/mm/yyyy)
Nationality
Phone Number
Email
2. EMERGENCY CONTACT
Full Name
Relationship
DATE OF BIRTH (DD/MM/YYYY)
Permanent Home Address
3. PROGRAM REGISTRATION
Please select your top two program choices
First-choice program --Choice--AccountingAgricultureAnimal HusbandryAquacultureAutomation and Control EngineeringAutomotive EngineeringBiotechnologyBusiness AdministrationChemical EngineeringChinese StudiesCommunity HealthConstruction TechnologyConstruction Technology of Traffic WorksCultural StudiesE-CommerceEarly Childhood EducationEconomicsElectrical and Electronic EngineeringEnglish StudiesEnvironmental TechnologyFinance-BankingFood technologyGeneral MedicineHotel ManagementInformation TechnologyKhmer LanguageKhmer Teaching EducationLawsManagement Information SystemsMechanical EngineeringMedical Imaging TechnologyMedical LaboratoryMinority Ethnic Cultures in VietnamMusical StudiesNursingNutritionOdonto – StomatologyOffice AdministrationPharmaceutical ChemistryPharmacyPhilology Teacher EducationPoliticalPreventive HealthcarePrimary EducationRehabilitationReligious StudiesResource and Environmental ManagementRestaurant and Food service managementSocial WorkSport ManagementState ManagementTraditional Instrument PerformanceTravel Services ManagementVeterinary
Second-choice program --Choice--AccountingAgricultureAnimal HusbandryAquacultureAutomation and Control EngineeringAutomotive EngineeringBiotechnologyBusiness AdministrationChemical EngineeringChinese StudiesCommunity HealthConstruction TechnologyConstruction Technology of Traffic WorksCultural StudiesE-CommerceEarly Childhood EducationEconomicsElectrical and Electronic EngineeringEnglish StudiesEnvironmental TechnologyFinance-BankingFood technologyGeneral MedicineHotel ManagementInformation TechnologyKhmer LanguageKhmer Teaching EducationLawsManagement Information SystemsMechanical EngineeringMedical Imaging TechnologyMedical LaboratoryMinority Ethnic Cultures in VietnamMusical StudiesNursingNutritionOdonto – StomatologyOffice AdministrationPharmaceutical ChemistryPharmacyPhilology Teacher EducationPoliticalPreventive HealthcarePrimary EducationRehabilitationReligious StudiesResource and Environmental ManagementRestaurant and Food service managementSocial WorkSport ManagementState ManagementTraditional Instrument PerformanceTravel Services ManagementVeterinary
4. ACADEMIC RECORDS
Names of High School Attended
High school’s Location
Year of High school Graduation
5. Certificate of English language proficiency (if any)
NOYES
6. Certificate of Vietnamese language proficiency (if any)
Attach file (BIRTH CERTIFICATE, PASSPORT, CERTIFICATE)
I confirm that the information I have provided on this application form is (to the best of my knowledge) true, accurate, current and complete; and I agree to notify the University promptly if any information contained on this application form should change, in order to keep it true, accurate, current and complete. I agree to the above terms and conditions.
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