Report Form to Study at Khon Kaen University

Student information

Title*

First name*

Middle name

Last name

Date of Birth*

Passport number*

Passport date of issue*

Passport date of expiry*

Nationality*

Status*
Single
Married
Divorced
Widowed

Working status before study at KKU*
Unemployed
Employed Position

Home address
Address*

Country*

Home telephone number*

Current address in Thailand
Address*

Thai telephone number

E-mail*

Parents information

Father's name

Occupation

Address
Same as home address
Other

Mother's Name

Occupation

Address
Same as home address
Other

Financial Support*
Self-funding
Scholarship

Please specify scholarship’s name, address and contact person.

Program study in home or previous school or university

Current student status*
Studying
Graduated

Program*

Faculty*

Expected year of graduation (if studying)/ Year of graduation (if graduated)*

GPA/ Grade results*

Program study in KKU

Type of study*
Full time
Short time

Degree*
Short course
Bachelor’s
Master’s
Doctoral
Other, please specify

Degree’s name*

Program*

Faculty*

Period of program*
1 Semester
2 Semester
Other, please specify

Program starts*

Program ends*

Contact person in case of emergency

Name*

Address*

Relationship*

Telephone number*

E-mail*

File Attachment

Photo* Self photo by your mobile phone is OK.

Example:

Passport* Identity information page.