Kokand State University

Personal Information

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Name (First Name) *

Patronymic (Middle Name)

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Date of Birth *

Place of Birth *

Nationality *

Citizenship *

Email Address *

Phone Number *

Permanent Address *

Temporary Address (if applicable)

Faculty *

Direction (Uzbek/Russian) *

Form of Education *

Previous Education *

Passport Series and Number *

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Marital Status *

Father's Information *

Mother's Information *

Passport Scan

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Medical Certificate (Form 086)

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Photo 3.5x4.5

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Certificate or Diploma

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