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Eligibility Check Form

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Laura Sihombing
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3 views

Eligibility Check Form

Uploaded by

Laura Sihombing
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as XLS, PDF, TXT or read online on Scribd
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INTERNATIONAL CHRISTIAN UNIVERSITY

ELIGIBILITY CHECK FORM


Date :

Name Sex M
Last First Middle (initial)

Date of Birth Email address


Year/Month/Day
Native
Nationality(ies)
Language(s)

EDUCATIONAL BACKGROUND
ELEMENTARY EDUCATION (e.g. grade school, primary school, etc.)
Year Language of
Name of School(s) Location Dates of Attendance (Grade) in
(City, State/Province & Country) (from Year/Month to Year/Month)
school
Instruction

SECONDARY EDUCATION (e.g. middle school, junior high school, senior high school)
Year Language of
Name of School(s) Location Dates of Attendance (Grade) in
(City, State/Province & Country) (from Year/Month to Year/Month)
school
Instruction

(Expected) Date of Graduation


Year/Month/Day
Website address of your high school you are graduated (expected to
graduate) from, if available

Have you taken/will you take national examination or completed/complete college-bound program which
qualifies you to enter four-year university in the country your high school curriculum is based?
YES

If yes, what is the name of the examination or the program?

HIGHER EDUCATION (university or college)


Year Language of
Name of School(s) Location Dates of Attendance (Grade) in
(City, State/Province & Country) (from Year/Month to Year/Month)
school
Instruction

(Expected) Date of Graduation


(Expected) Date of Graduation
Year/Month/Day

Degree obtained (Associate, Bachelor, Master etc.):


F

Language of
Instruction

Language of
Instruction

N
YES
O

Language of
Instruction

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