INTERNATIONAL

star.educonsult@gmail.com info.ukraine@yahoo.com
STUDENTS
APPLICATION FORM www.Edu-Ukraine.com www.facebook.com/SECUkraine
STUDY IN UKRAINE
+380 98 888 00 87

Name and contact information ↓PERSONAL DETAILS ↓

NAME: ↓Your legal name ↓Fill APPLICATION form in CAPITAL words i.e. clear, visible, understandable

Family (last) name ↑ First name ↑ Middle name ↑

  - -
Place of birth↑ Nationality by birth↑ Male Female Day Month Year
Sex ↑ Date of birth ↑

Current Nationality↑
↓PROGRAM↓
Current Qualification →
Medium of Instruction
→ Chose the language to study your program
Int’l Passport No.↑
↓INTAKE↓
 January-March Entry 2020/21
 September-November Entry 2020/21
 Preparatory (anytime)
Higher Secondary School Cert. Bachelor
Master Ph.D.
 English Russian Ukrainian
Passport Issue & Expiry Date↑ Write the Country where you will
receive Ukrainian visa↑
I do not know English well & first year want to join Preparatory
for language training (English, Russian or Ukrainian)

Specialist
Other ________________
Degree Bachelor Specialist
sought→ Master Ph.D.

↓VALID POSTAL ADDRESS & CONTACT NUMBERS (Invitation letter will be forwarded later to this address) ↓

Street number and street name ↑ City, State& Province ↑

or ↑ Zip or Postal Code & Country ↑ Email address↑

.→
Whats app Number ↑ Viber Number ↑ Contact Number ↑

Applicant's Signature: → Date: →

→ Provide following documents to support your application, and send them to the emails given at the bottom of this form
 Filled Application Form (with valid permanent/ current postal address and telephone numbers)
 International Passport, the page with picture and data on it (traveling document)
 Educational Documents available (Certificate of O level/A level /SSCE/ HSSCE/ WAEC/ NECO or Any Equal Certificate +
transcripts for all studies years/ Bachelor or Master’s degree certificates transcripts for all studies years)

→ I solemnly affirm that information given above is true and documents are genuine and available to support my application. I
am aware that Higher Education in Ukraine is not a SCHOLARSHIP or FUNDED from Ukraine. I declare that my family and I
are financially capable of paying all expenditures to accomplish my Education in Ukraine. I confirm that I wouldn’t stop my
admission procedure at any point or cancel my invitation letter once it is issued.

___________ Applicant's Signature

Your
star.educonsult@gmail.com info.ukraine@yahoo.com
Current
info@Edu-Ukraine.com +380 98 888 00 87
Picture
www.Edu-Ukraine.com
www.facebook.com/SECUkraine
 Information

Ukrainian State Center for International Education State Enterprise at the Ministry of Education and

Science of Ukraine

In accordance with the Procedure for issuing invitations to foreigners and stateless persons for studies
(internship) in Ukraine and their registration as approved by Order N 1541 of the Ministry of Education and
Science of Ukraine dated 1 November 2013 and registered with the Ministry of Justice of Ukraine on 25
November 2013 under N 2004/24536, and to secure the guarantees of the MES of Ukraine as to the
authenticity of issued invitations to enter Ukraine for educational purposes, all invitations for studies issued
by educational institutions to foreigners are subject to registration with the electronic system of the Ministry
of Education and Science of Ukraine. Personal data of prospective foreign students used during the
registration of invitations as incorporated in the statutory form of the Invitation for Studies will be used
solely for the purpose of entering to the account database of invitations and, as may be required, providing
visa support to foreigners invited to study in Ukraine.

________________________________________________________________________________

Consent

to personal data collection and processing

I, _____________________________________________________________________________,

do hereby give my consent to the Ukrainian State Center for International Education State Enterprise,
the Ministry of Education and Science of Ukraine, acting pursuant to the Law of Ukraine on Personal Data
Protection, for collecting and processing my personal data in account files (databases), including electronic
ones, which the Enterprise is authorized to maintain by the Ministry of Education and Science of Ukraine
within the statutory goals and objectives of the Enterprise and for possible transfer them to the diplomatic
missions of Ukraine abroad and to the diplomatic missions of other states accredited in Ukraine, according
to my nationality, and other third parties in case of a request according to Article 16 of the Law of Ukraine
"On Personal Data Protection".

The following personal data may be processed:

- passport data: full name, the date of birth, series, number and the date of issuance of the passport, and the
nationality;

- country of residence;

- gender;

- a document (documents) confirming education.

____ ________________ 2019, ___________________ (__________________________________)

(date) (signature) (Full name)