ACADEMIC YEAR

APPLICATION FORM BANGKOK UNIVERSITY (BU CROCCS)

Personal Details
Title:
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Name:
First Name Middle Name Last Name
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Details:
Date of Birth Nationality Religion
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Contact:
Telephone Mobile E-mail
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Citizenship:
Country of Citizenship Country of Birth
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Foreign Students only
Visa Details:
Visa type Visa Expiry Date Passport Number
Education
Institution:
Name of Institution Year Completed
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Mailing Address:
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Major/Course Preferences

I certify that the information provided in this application is complete and accurate. I understand that making false statements, (providing incorrect information, or violating any university's rules and regulations may result in the denial of my admission.

I hereby agree and consent that the Bangkok University may collect, use, process and disclose my personal data, provided in this form or collected from other people or entities by Bangkok University or its agent for the purpose of admission or the benefit of the Bangkok University's business. I also acknowledge, agree and consent the Bangkok University has the right to collect, use, process and disclose my personal data to be in accordance with the Privacy Policy, prescribed by Bangkok University and the amendment thereof.

Please provide your signature
Applicant's signature