Kingdom of Cambodia

Nation

Religion

APPLICATION FOR ADMISSION

King

4x6

ACADEMIC YEAR: 20.. - 20..

Student ID

SECTION 1: PROGRAM PREFERENCES

Please tick where applicable.

Program
Study Group

Bridging Course

Afternoon Evening

Morning

Bachelors degree
Weekends (Saturday +Sunday)

Sunday Only

SECTION 2: FACULTIES AND MAJORS

Please tick where applicable.
FACULTIES

Business Administration
Education, Arts and
Humanities

MAJORS

General Management

Accounting

Marketing Management

Teaching English as a

English and Business

English Translation and

Foreign Language, TEFL

Communication

Interpretation

Law and Social Sciences

Economic Development

Finances and Banking

International Relations

Tourism and Hospitality

Tourism Management

Hotel Management

Hospitality Management

Civil Engineering

Construction Engineering

Architecture and

Software Engineering

Engineering and
Architecture
Information Technology
and Science

and Management

Urbanization

Computer Systems and

Networking

Computer Multimedia
Design

SECTION 3: PERSONAL BACKGROUND

Name in Khmer
Name in Latin

First Name

Sex

Male

Last Name
Female

Marital Status Single

Passport No.

Expiry Date

Nationality
Date of Birth

Married

Country
Day

Month

Year

Place of Birth
Latest Degree

Institution

Permanent
Home Address

Current Address
Phone

E-mail
1

SECTION 4: EDUCATIONAL BACKGROUND

Schools Attended

Primary Education

Secondary Education

Higher Education

Name of School

Academic Year

Province/City
English Proficiency

Elementary Pre-Intermediate Intermediate Upper-Intermediate Advanced

Have you taken any English test(s)?

Yes

No

Please list the English test(s) you have taken before.

Name of Test

Place of Test

Date of Test (dd-mm-yy)

Result

1.
2.
3.
SECTION 5: FAMILY BACKGROUND

Fathers Name
Nationality

Age
Country

Occupation

Current Address
Phone

E-mail

Mothers Name
Nationality

Age
Country

Occupation

Current Address
Phone

E-mail

Guardians Name
Nationality

(If applicable) Age

Country

Occupation

Current Address
Phone

E-mail

Spouses Name
Nationality
Phone

(If applicable) Age

Country

Occupation
E-mail

SECTION 6: ATTACHMENT

1. One copy of Application for Admission with a photograph and an Admission Slip
2. Three passport-sized (4 x 6) color photographs (Please see the requirements on page 3)*
3. Two photocopies of High School Diploma/the equivalent certificate certified by the City Hall
(For Bachelors degree Application)

SECTION 7: DECLARATION

I declare that the above information and supporting documents are accurate and true. If there is any incorrect or
untrue information, I will be responsible for the consequences.
I promise that I will abide by the Internal Regulations of BELTEI INTERNATIONAL UNIVERSITY. If I commit any
infringements, I will be responsible for the consequences.
CONTACT ADDRESS IN PHNOM PENH

APPLICANTS SIGNATURE AND NAME

Name:..
#.... St... Group...
Sangkat..Khan....
Phnom Penh Capital City.

Phone.

Phnom Penh, DD..MM.YYYY.

RECEPTIONISTS SIGNATURE AND NAME

..

Phnom Penh, DD..MM.YYYY.

Please read the attached Internal Regulations of BELTEI INTERNATIONAL UNIVERSITY.

Basic Photo Requirements:
- In color
- Taken within the last 12 months to reflect their current appearances
- Taken in front of a plain blue background
- Taken in white blouse only (For Female Students)
- Taken in white shirt, a tie and black jacket (For Male Students)
- Do not wear a hat or glasses

Admission Slip
Name in Khmer
Name in Latin

4x6

asd

Sex

Male

Date of Birth

Day

Female

Marital Status
Month

Single

Married

Year

Place of Birth
Current Address
Telephone
Bachelors degree

Bridging Course

Program
Morning

Study Group

Afternoon

Evening

Weekend

Sunday

Receptionists Signature and Name

Applicants Signature and Name

Phnom Penh, DD...MM...YYYY...

Phnom Penh, DD...MM..YYYY..

Admission Slip
Name in Khmer

4x6

Name in Latin
Sex

Male

Date of Birth

Day

Female

Marital Status
Month

Single

Married

Year

Place of Birth
Current Address
Telephone
Bachelors degree

Bridging Course

Program
Study Group

Morning

Afternoon

Evening

Weekend

Sunday

Receptionists Signature and Name

Applicants Signature and Name

Phnom Penh, DD...MM...YYYY...

Phnom Penh, DD...MM..YYYY..