New Student

PERSONAL INFORMATION

Username KH*

Username EN*

Gender*

Date of Birth*

Nationality*

How do you know Angkor University *

CONTACT INFORMATION

Preferred Phone*

Alternative Phone

Email*

Current Address *

EMERGENCY CONTACT

Parent / Guardian Name *

Phone *

Email

EDUCATION

Current or most recent Secondary / High Schools *

Graduation / Exit Date *

Please list any other Secondary / High Schools :

Graduation / Exit Date :

PERSONAL GOAL

Please explain in 1 or 2 sentences the reasons for which you want to study towards the Bachelor of Nursing.

COMMITMENT TO STUDY

I will try my best to support Angkor University and other students.

TERMS AND CONDITIONS

I declare that the information given in this form is true and correct, and if accepted as a student, I will comply with all the conditions, rules and regulations of the institute including the rules and code of conduct in the Student Rulebook | Policy.

I have read, understood, and accepted all above statements.

Bachelor of Science in Nursing, Bridging Course Program of Nursing Application Form