Yes

No

Number of
Children

Marital Status

Married

Issue Place

City

Single

Issue Date

Province / State

School Attended in Chronological Order

Medium

Major

Stage /
Certificate

Completion
Date

Date of Birth

Original Nationality

Current Nationality

ID Card or Passport #

Country

About Residence & Place of Birth

Place of Birth

Present Place of Residence

Familys Place of Residence


Admit ion
Date

Duration of
Study

Governmental
or Private

Location

Personal Information

First Name

School Name
1
2
3
4

Fathers
Name

Applicants Quadruple Name
As Per Documents

In Arabic

In English (Block Letters)

Is your name given in your passport the same as it is in your educational documents ?
If not, please state the difference ::

Grandfathers
Name

Surname

5
6

8
9
10

Source

Grade

Level

..

Type
Private
Governmental
Percentage: :
Total Marks

Last Acquired Certificate
When Awarded

Major :

..
..

. :
Note : If private School is not Under Government Supervision, Please State Supervising Authority.

Educational Information

Faculty of the Holy Quran & Islamic Studies

Faculty of Arabic Language

Faculty of Dawa & Theology

Faculty of Sharia

Intermediate

secondary
In Arabic

Pre-University Stage

Phone #

..
Fax #

..
Phone #

..
Fax #

..

.
In English (Block Letters)

Applicants Mailing Address

.
In Arabic

.
In English (Block Letters)

.

Name & Address of the Islamic

Center, if any applicant is
affiliated to.

,
. .
I hereby testify and confirm that all the foregoing information is true and correct. Also that all attached documents are
authentic and free from distortion and forgery. I further undertake to abide by the rules and regulation of the Islamic
University if I am accepted in case of any violation. The University has the right to take any action it deems fit.
Date :

Signature :

..

Applicants Name :

General Information

Faculty of Hadith & Islamic Studies

Applicant Choice

Address

:
University Stage : An applicant is requested to arrange the following faculties according to priority ?

Islamic University ?
Have you Applied for Admission to Admission to the Islamic
any other Saudi University ?
University
Before ?
No ) (
Yes ) (
No ) (
Yes ) (
No ) (
Yes ) (
.. :
Specify the country that has a Saudi Embassy Where you wish to apply for entry visa to the kingdom in case you are
accepted :

Undertaking

State Your Arabic Language Skills & Proficiency

:
Poor ) (
Good ) (
Excellent ) (
Institute :
:
Student) (
Stage of Studies: :
..

Present Status ( Your Profession )
Job Place :
:
Employee) (
Job Title: :
..


Have You Ever Applied for
Do You Have Any Information About

State the amount of the Holy Quran you have memorized :