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INTRODUCTORY STATEMENT ‫وﺛﻴﻘـﺔ ﺗﻌــﺎرف‬

*Full Name: ................................................................................................................................... :‫*اإلسم اﻟﻜﺎﻣﻞ‬

*Family Name: :‫*إسم اﻟﻌﺎﺋﻠﺔ‬
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*Place of Birth: :‫*ﻣﻜﺎن اﻟﻤﻴﻼد‬
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*Date of Birth: ................................................................................................................................... :‫*ﺗﺎرﻳﺦ اﻟﻤﻴﻼد‬
*Present Nationality: :‫*اﻟﺠﻨﺴﻴﺔ اﻟﺤﺎﻟﻴﺔ‬
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*Sponsor Upon Entry: ................................................................................................................................... :‫*الجهة الراعية عند الدخول‬
*Date of Entry to UAE: ................................................................................................................................... :‫*ﺗﺎرﻳﺦ دﺧﻮل اﻟﺪوﻟﺔ‬
*Port of Entry: ................................................................................................................................... :‫*ﻣﺮﻛﺰ اﻟﺪﺧﻮل‬

*Previous Nationality: :‫*اﻟﺠﻨﺴﻴﺔ اﻟﺴﺎﺑﻘﺔ‬

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*Religion: ................................................................................................................................... :‫*اﻟﺪﻳﺎﻧﺔ‬

*Sect: ................................................................................................................................... :‫*المذﻫﺐ‬

Passport & Residence: :‫بيانات الجواز واإلﻗﺎﻣﺔ‬

*Passport No: ................................................................................................................................... :‫*رﻗﻢ اﻟﺠﻮاز‬

*Place of Issue: :‫*مكان اإلصدار‬
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*Date of Issue: :‫*تاريخ اإلصدار‬
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*Date of Expiry: ................................................................................................................................... :‫*تاريخ اإلنتهاء‬

Qualification: :‫المؤهالت‬

*School/University: ................................................................................................................................... :‫الجامعة‬/‫*المدرسة‬

*Date of Graduation: ................................................................................................................................... :‫*تاريخ الحصول على الشهادة‬
*Country: ................................................................................................................................... :‫*الدولة‬
*Languages Spoken ................................................................................................................................... :‫*اللغات التي تجيدها‬

Residence Details outside UAE: :‫بيانات السكن خارج الدولة‬

*Country: ................................................................................................................................... :‫*الدولة‬

*City: :‫*المدينة‬
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House/Building No./Street: ............................................................................................................................ ‫ الشارع‬/‫البناية‬/‫رقم المنزل‬
Res. Tel No.: :‫رقم الهاتف‬
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*Mobile No.: :‫*رقم الهاتف المتحرك‬
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P.O. Box /ZIP code: :‫رقم صندوق البريد‬
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I, the undersigned, undertake that details contained in this statement ‫أتعهــد أنــا الموقع أدناه بأن البيانات الواردة بهذه الوثيقة صحيحة‬
are correct and complete enclosure. .‫وكاملة المرفقات المطلوبة‬

*Name: :‫*االسم‬
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*Signature: :‫*التوقيع‬
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*Date: :‫*التاريخ‬
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*Please fill all mandatory field ‫*يرجى تعبأة جميع الحقول االلزامية‬

V.2019/1