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Please download this application form and return the completed form to:
Republic of Yemen
Al Hadeitha Co.
Sana’a, Hadda City
Faj Attan Street
infront of Azal University

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Please complete the form below to apply online.

Preferred academic program    

Student Details
Full Name
Date of Birth
Place of Birth
Passport Number
Martial Status
Mailing Address
P. O. Box

Parents/Guardian Details
                                                                     Please provide us with details about your Father/Mother/Guardian:
Telephone Home
Telephone Work

General Undergraduate Admission Requirements
List the secondary school from which you graduated and any universities you have attended with dates of attendance:
Name of School/University          Location (Country)         Dates of Attendance
Indicate type of secondary certificate you hold or expect to receive and the date received:
Other (Specify):   
If the certificate is the British IGCSE, GCSE, GCE, the IB Diploma, or similar, specify subject, level and result.
Subject            Level           Result           
For students applying to EIU, International Internet based TOEFL (61), or Academic IELTS (5.0) is required. Please specify the test you intend to take or have already taken in the space below:
Those who do not meet the English proficiency stated above are required to take the placement test at EIU to determine their placement in the intensive language levels offered
Do you have any physical disabilities? (This information is voluntary and confidential; it is requested to help the University provide aid and support, as much as possible.)
Other (please explain):
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