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Application Form-Poland PDF

Omar Maati from Morocco is applying for studies in Poland for the 2020/2021 academic year. He provides his personal details including his date of birth, parents' names, address in Temara, Morocco, and contact information. He attended high school in Skhirat, Morocco from 2018 and received his high school certificate. He does not have any post-secondary education. Omar has intermediate English skills and agrees to have his personal data processed as part of his application.

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551 views3 pages

Application Form-Poland PDF

Omar Maati from Morocco is applying for studies in Poland for the 2020/2021 academic year. He provides his personal details including his date of birth, parents' names, address in Temara, Morocco, and contact information. He attended high school in Skhirat, Morocco from 2018 and received his high school certificate. He does not have any post-secondary education. Omar has intermediate English skills and agrees to have his personal data processed as part of his application.

Uploaded by

fati
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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“Education in Poland”

APPLICATION FORM
FOR THE ACADEMIC YEAR 2020 / 2021
I would like to apply for the following studies at University in Poland

PERSONAL DATA – fill in capital letters


Name Surname

OMAR MAATI
Middle name Gender
MALE FEMALE

Date of birth – day / month / year Place of birth

12/03/1997 TEMARA/ MOROCCO

Parents name and surname


Name Surname Name Surname
Father AHMED Mother
MAATI ZAHRA MAATI
ID / Passport number Nationality Country of permanent residence
OB8593965 MOROCCIANE MOROCCO

Visa number Residence card number

PERMANENT ADDRESS
Postcode Street Home / flat number
12006 LOT KORA SKIKIMA IMM 03 APT 03

City / town Village Country


TEMARA TEMARA MOROCCO

PLACE OF RESIDENCE
Cities Towns and suburbs Rural areas
Densely populated areas Intermediate density areas Thinly populated areas
Telephone number E-mail address
[email protected]
+380956422807

CORRESPONDENCE ADDRESS – fill in if different then above


Postcode Street Home / flat number

12006 LOT KORA SKIKIMA IMM 03 APT 03


City / town Village Country
SKHIRAT TEMARA MOROCCO
TEMARA/TEMARA
“Education in Poland”
APPLICATION FORM
FOR THE ACADEMIC YEAR 2020 / 2021
SECONDARY SCHOOL, COLLEGE / UNIVERSITY OF CANDIDATE DATA
SECONDARY SCHOOL
Attended school Town / City Country
SKHIRAT (MUN) . LIBR SKHIRAT TEMARA/TEMARA MOROCCO

Type of received certificate No. of certificate


HIGH SCHOOL CERTIFICATE 13947078/18

Dates of attended school Country


2018
Beginning 2018 End MOROCCO
COLLEGE / UNIVERSITY
Attended college / university Town / city Country

Type of received certificate Number of Diploma

Dates of attended college / university Year of graduation


Beginning End
Type of awarded degree
Bachelor degree Master degree None
College / University programmes / courses

ENGLISH LANGUAGE KNOWLEDGE


English language certificates

Name of examination

Grade / score Date of examination

Level of knowledge
Elementary Intermediate Advanced Proficiency

Reading

Writing

Speaking
“Education in Poland”
APPLICATION FORM
FOR THE ACADEMIC YEAR 2020 / 2021

OTHER DATA
IN CASE OF EMERGENCY PLEASE CONTACT
Name Surname Relationship

AHMED MAATI FATHER


Address Telephone number E-mail
LOT KORA SKIKIMA IMM 03 APT +380956422807 [email protected]
03 TEMARA / MOROCCO

WOULD YOU LIKE TO APPLY FOR ACCOMMODATION ?


No Single room Double room Triple room Apartment
SOURCE OF INCOME
Own business activity Own job Farm Allowances

Parents job Pension Other


WORKPLACE
Employer's name

Address
DISABILITY
DEGREE OF DISABILITY

TYPE OF DISABILITY

I agree to the processing of my personal data included in the application for recruitment, according to the Act of 29 August 1997
on Personal Data Protection, DZ. U. Nr 101, poz. 926 as amended. I declare that the statements made by me on this form are to
the best of my knowledge and belief, true and correct. If my application is accepted I will follow the university’s regulations and
ensure payment of fees and other liabilities.

___________________________

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