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APPLICATION FORM
CHOOSE THE INSTITUTION
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Salutation: Mr/ Ms
Name: Zareen Qidwal
FatherName: Adee! Anmad Qidwai
Mother Name: Parveen Qidwal
Daeottity 08 | 07 J 1 9 9 4
Gender Male Female
Nationaty: India
PassportNo, 24164430
CourseName: Bed
Specialization:
Session: Year 2023 Month july
U1) ) i Cel DB toy Latah Aiea Last ed
Address (Steet, Number)* 19A Amman street ‘Address (Steet, Numben* 19A , Amman Street
Postal Code Postal Code
cays Dubai cy Dubai
county UAE county* UAE
Phone? 0545491189 Phone? 0545491189
Emait _Zareen.kidwal25@gmail.com Email Zareen.kidwal25@gmail.comSecondary School 2009 UP. Board
Sr Secondary 2014 UP . Board
Under Graduation 2014 Lucknow University
Post-Graduation 2016 Lucknow University
MPhil
Pho
other
same AEN
Current Employer:
Ini Poston
Department
Time Period:
Curent Psion:
Department
REQUIRED DOCUMENTS
Complete cv
Copies of Degree
Transcript or Mark sheet
Work Experience Letter
Passport Size Photo
Copy ofPassport
Copy ofvisaResidence Permit
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By submitting your application you agree to the terms and conditions as follows:
L
Univers College. understand and accept the tems, rules and regulations ofthe University that govern the admission proceciure
| certily that | understand that | must satisfactonly meet the admission requlrements to be accepted for entolment into the LUC programs
| agree to mect my financial obligations to Learners University College in full and by the due date provided to me by invoice and understand
that ill aot be Permitted to enral or gracuate if fil todo 0,
| understand that ial withdraw from a course by the relevant advised withdrawal dates willincur the fll fes for that course
| understand that alla course and are required to re-enrllin order to meet the requirements of the awa will incur fees fr th
reenrolment.
understand thatif exceed the minimum candidature period prescribed by LUG Iwillincur candidature extension fees, subject tomy making
satisfactory Progress during the course of my caneidature, and commitment to progress milestones.
| understand that policy, procedures, and financial obligations may be amended at the discretion of Leamers Unversity College
lam responsible ro meet allthe requirements fo the course 1am enrolled or at LUC,
Learners University College preferred method of communicaton with students \s by email and Iwill be responsible for checking my student
temailaccount ona regular basis, as well as anyother accounts provided with this application form. willbe responsible for notifying university
in caseof any changed in my registered contact details. (email address/contact number ete)
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Students’ Personal Information policy
“= hereby apply for admission to the —————-——--__.. program at Learners
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‘enrolment wl be used in administering the eanners University College program, which involves the use of extemal service providers Where
itis necessary to involve a thi party service provide, Learners University College ensures that a confidentiality agreement isin place to
protect your personal details ane will only supply detall which ae necessary to provide the agreed service. Your enrolment will be an
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Ee reese
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Is correct and complete have rea the relevant aémission requirements fee policy, privacy statement and course structure information,
acknowledge that is my responsibly to ensure that seek advice onre-enrolment and variances to my re-envolment that Imay eur
agree to pay any fees and charges up front each study period fr any unis to enroll in. acknowledge that while Lam ervoed ina Learners
‘University College program | am subject to the legislation, polices and procedures ofthat program and terms & conditions of Learners
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