Application - Inbound Student Exchange

1. Personal Information

Full Name (First name then Last name)

Home University Name

Date of Birth

Nationality (as in passport)

Marital Status

Passport Number

Expiration Date

Address

Mobile No (please inclulde the country code)

Email (your personal email)

Do you have any medical conditions / disabilities / special needs? If yes, describe:

Passport copy (colored) (JPEG format)

High School Certificate copy (JPEG format)

University Transcript (PDF format)

Photograph 6x4 (JPEG format) (white background, straight, no effects or pose)

Visa Form (PDF)

Learning Agreement (darft only) (Word document)

*CV / Resume (Optional) (PDF format)

Emergency Contact Name

Relationship

Emergency Contact Address

Emergency Contact Telephone

2. Academic Information

College Please Select College of| Medicine College of| Mass Communication College of |Pharmacy and Health Sciences College of| Dentistry College of |Engineering and Information Technology College of| Architecture, Art and Design College of|Business Administration College of| Humanities and Sciences College of| Law

AU program (eg: Marketing, Data Analytics,etc)

Intended Semester Fall Spring Summer

Intended period of exchange (From)

Intended period of exchange (To)

Home Institution

Institution Address

Point of Contact/ Coordinator of Exchange

Telephone

Email

*CV/Resume is required when applying for an internship. Please confirm that you have provided accurate documents. Ajman University PR office will provide you with assistance in getting the student’s VISA.