2018/15705

Misr International University

Application for Admissions
2018/2019

Personal Data (Please write your name as it appears on the Birth Certificate.)
MIU ID: 2018/15705

First Name: Ehab Middle Name: Hamada Last Name: Mohamedy

Nationality: Egyptian Gender: Male

Date of Birth: May 2, 2000 Place of Birth: Egypt

Religion: Muslim

Student's Mobile: 01284688595 E-mail Address: [email protected]

National Id: 30002051701655

ϱΩϣΣϣϩΩΎϣΣΏΎϬϳ΍ ΔϳΑέόϟ΍ΔϐϠϟΎΑΩϼϳϣϟ΍ΓΩΎϬηϲϓΕΑΛϣϭϫΎϣϛϝϣΎϛϟΎΑϡγϻ΍

Family Information
Name of Father / Legal ϩΩΎϣΣ Mother's Name: Reda
Guardian:
Profession : ΎϧγϳϭϗϪϧϳΩϣαϠΟϣΑϑυϭϣ Profession Category: Accounting Company: ΎϧγϳϭϗϪϧϳΩϣαϠΟϣ

Business Address : Ύϧγϳϭϗ

Telephone: 0482562972 Mobile: 01155032519

E-mail Address: [email protected] Fax:

Brother/Sister in MIU: No

Address Information
Building No: 1 Street Name: ϩϭέϣϟ΍ϭΎϔλϟ΍

Area: ΎϧγϳϭϗίϛέϣϪϳϓϭϧϣϟ΍ City: Menoufia Country: Egypt

Home Telephone: 0482562864

εϳηΑ΍έϔϛϪϳέϗ?Ύϧγϳϭϗίϛέϣ?Ϫϳϓϭϧϣϟ΍ ΔϳΑέόϟ΍ΔϐϠϟΎΑϥ΍ϭϧόϟ΍

Preferred Placement Exam Date

English Date: August 12, 2018 Time: 12:30 To 14:30
Admission Information
Semester Applied for: 18F

Major Applied For:

First Choice Dentistry Second Language French

Second Choice Pharmacy
Third Choice AL Alsun

Declaration
I Ehab Hamada Mohamedy, Id 2018/15705 hereby state that I ϥϣϱ΄ΑϕΎΣΗϟϻ΍ϝΑϗ΃ϲϧϧ΄Α2018/15705ΏϟΎρϟ΍ϡϗέϱΩϣΣϣϩΩΎϣΣΏΎϬϳ΍Ύϧ΃έϗ΃
accept to be enrolled in any of the faculties listed in this request ΕΎΑϠρΗϣϭΔΣΎΗϣϟ΍ϥϛΎϣϷ΍ΏγΣΏϠρϟ΍΍ΫϬΑΔΟέΩϣϟ΍ΕΎΑϏέϟ΍ϲϓΓΩέ΍ϭϟ΍ΕΎϳϠϛϟ΍
according to the capacity and admission requirements of each. ΎϬϧϣΔϳϠϛϝϛΑϝϭΑϔϟ΍
Student's Name: ϢγϷ΍

Student's Signature: ϊϴϗϮΘϟ΍

Date: ΦϳέΎΘϟ΍

Certificate & School Information

Egyptian Thanawia Amma Science

Others (state type of Certificate)

Name of School: Om Khanan Secondary School in Year of Graduation: 2018

Menoufia
Country: Egypt City: Menoufia Percentage:

Additional Information
How did you know about MIU ?
- Friends

In case of emergency, please contact : ˮΔϠ΋ΎόϟΎΑϝΎμΗϼϟΔϘϳήρωήγ΃ϲϫΎϣˬΉέΎρϱ΃ΙϭΪΣΔϟΎΣϲϓ

Name : Mohamed Hamada
Relation : brother
Address : monoufia
Mobile: 01227568914
Email: [email protected]
Telephone : 0482562864
Declaration
Declaration έ΍ήϗ·
I certify that I have carefully considered each question and that my ϥ΃ϢϠϋϰϠϋϲϧ΃ϭˬΔΤϴΤλΔόϣΎΠϠϟΎϬΘϣΪϗϲΘϟ΍Ε΍ΪϨΘδϤϟ΍ϭΕΎϣϮϠόϤϟ΍Ϟϛϥ΃ήϗ΃
statements are true and complete.I understand that giving false information ΐΗήΘϳϥ΃ϥϭΩΔόϣΎΠϟ΍ϦϣϞμϔϠϟϲϨοήόϳϪΘΤλϡΪϋΖΒΜϳΪϨΘδϣϭ΃ΔϣϮϠόϣΔϳ΃
or submitting forged documents will make me subject to dismissal from the ΔόϣΎΠϟ΍ϯΪϟϲϟϕϮϘΣΔϳ΃ϚϟΫϰϠϋ.
university. ΔόϣΎΠϟ΍ϯΪϟΎϴΑΎΘϛϪΗΎΒΛΈΑΪϬόΗ΃ΔϘΑΎδϟ΍ΕΎϧΎϴΒϟ΍Ϧϣϱ΃ήϴϴϐΗΔϟΎΣϲϓϭ
If any of the above mentioned documents or information changes, I commit Ω΍ΪδΑϲϣ΍ΰΘϟΎΑϡΎΗϢϠϋϲϠϋϲϨϧ΍ΎϤϛ
myself to provide a written verification to the university ΕΎΑΎδΤϟ΍Γέ΍Ω·ϞΒϗϦϣΓΩΪΤϤϟ΍Ϊϴϋ΍ϮϤϠϟΎϘΒρϭΔγ΍έΪϟ΍Ϟμϔϟ΍Δϳ΍ΪΑϞΒϗΕΎϓϭήμϤϟ΍
I am fully aware of the fact that all fees and tuition must be paid in full prior
ΔϴϟϭΪϟ΍ήμϣΔόϣΎΠΑ
to the beginning of each semester according to the date set by the
accounting department.

Student's Signature: ΐϟΎτϟ΍ϊϴϗϮΗ

Parent's / Guardian's signature : ήϣϷ΍ϲϟϭϊϴϗϮΗ

Date: ΦϳέΎΘϟ΍

Revised by Admissions staff Member:

Date:
 Medical Insurance
2018/15705

ŜƫŚƐƫ¦©ŚƳŚǀŝ

ϥΎϨγϷ΍ϭϢϔϟ΍ΐρΔϴϠϛ ΔϴϠϜϟ΍ 2018/15705 ΐϟΎτϟ΍Ϣϗέ

May 2, 2000 ΩϼϴϤϟ΍ΦϳέΎΗ ϱΪϤΤϣϩΩΎϤΣΏΎϬϳ΍ Ϣγϻ΍
ΔϴϋΎϤΘΟϻ΍ΔϟΎΤϟ΍ ϱήμϣ ΔϴδϨΠϟ΍
0482562864 ϝΰϨϤϟ΍ϥϮϔϴϠΗ ζϴθΑ΍ήϔϛϪϳήϗ?ΎϨδϳϮϗΰϛήϣ?ϪϴϓϮϨϤϟ΍ ϥ΍ϮϨόϟ΍
01227568914 ϪϧϮϔϴϠΗ Mohamed Hamada Ήέ΍Ϯτϟ΍ΔϟΎΣϲϓϪΑϝΎμΗϻ΍ϦϜϤϳκΨηϢγ΍

ΪΟϮϳϻ ΔϘΑΎγν΍ήϣ΃Δϳ΄ΑΔΑΎλϹ΍ϲοήϤϟ΍ΦϳέΎΘϟ΍
ΪΟϮϳϻ ΔϴπϳϮόΗΓΰϬΟ΃ϊϤγΔϳήμΑΕ΍ΪϋΎδϣϡΪΨΘδΗϞϫ
ΪΟϮϳϻ ΔϨϣΰϤϟ΍ν΍ήϣϷ΍
ΪΟϮϳϻ ΔϴΣ΍ήΠϟ΍ΕΎϴϠϤόϟ΍
ΪΟϮϳϻ ΔϣΪΨΘδϤϟ΍ΔϳϭΩϷ΍

ν΍ή˰˰˰ϣϷ΍ϭϥΎϨγϷ΍ΝϼϋϭˬΎϬΗΎϔϋΎπϣϭˬΔόϣΎΠϟΎΑϕΎΤΘϟϼϟΔϘΑΎδϟ΍ϭΔϨϣΰϤϟ΍ν΍ή˰˰ϣϷ΍ϊϴϤΟ
ϖΣΔόϣΎΠϟ΍ΐϴΒτϟϭˬϲΤμϟ΍Ϧϴϣ΄Θϟ΍ϡΎψϨΑϩΎτϐϣή˰˰ϴϏˬΎϬόΒΘϳΎϣϭϞϴϤΠΘϟ΍ΕΎΣ΍ή˰ΟϭΔϴδϔϨϟ΍
ν΍ή˰˰˰ϣϷ΍ϩάϫΔόϴΒρΪϳΪΤΗϭή˰˰ϳή˰˰˰ϘΗ
ΏϟΎρϟ΍ϊϳϗϭΗ ΦϳέΎΗϟ΍
................................. 20 / /
 2018/15705

English

Student I.D. : 2018/15705

Student Name : Ehab Hamada Mohamedy

Applied for Major : Dentistry

Exam Date : August 12, 2018 Exam Time: 12:30 To 14:30

User Name: 2018/15705 Password: 7o84

One parent only is allowed to accompany you on the day of the exam.
Thank You

ϥΎΤΘϣϻ΍ϡϮϳΐϟΎτϠϟςϘϓΪΣ΍ϭϖϓ΍ήϤΑϻ·΢ϤδϳϻΔόϣΎΠϟ΍ϲϓϡΎψϨϟ΍ϰϠϋΎυΎϔΣ

ήϜθϟ΍ϊϣ

Please turn over

English

Student I.D. : 2018/15705

Student Name : Ehab Hamada Mohamedy

Applied for Major : Dentistry

Exam Date : August 12, 2018 Exam Time: 12:30 To 14:30

Admission Officer