Academic Bridge Program Admission Application Form Academic Year 2015-2016 Fall 2015 Semester Early Admission DEADLINE: 30th April 2015 Standard Admission DEADLINE: 15th July 2015 Application Instructions: All sections of this application must be fully completed in ENGLISH. The following documents must be submitted with the completed application form: 1. Official copy of High School Certificate scores. 2. Application fee of QR 500 (non-refundable) to be submitted with the application. 3. Two recent passport-size photographs. 4. Copy of ID card and passport. 5. Copy of iBT TOEFL/IELTS score report If you need Education City housing facilities please contact ABP Student Services to fill the forms and learn more about housing fees payment. Corporation and the Higher Education Institute sponsorship is available for Qatari students. The current tuition for Qatari students who prefer Family Sponsorship is 52,250QAR per year. Current tuition for non-Qatari students is 63,250QAR per year. A 2000 QAR deposit is required from private payers after they are admitted. PART 1 STUDENT INFORMATION: (Be sure to write your name and identification number exactly as they appear on your National Identification Card.) Full Legal Name: _____________________________________________________ (First) (Second) (Last Name) (either) National Identification Card Number: _____________________________ (and) Passport Number: _________________________________________________ Date of Birth: MM / DD / YYYY Male Female __________________________________________________________________ Country of Origin/Nationality : Mother:_____________Father:______________ Country of Current Residence: Qatar Other (Please specify) _____________________________ 1 Permanent Mailing Address: Street Address / PO Box: ________________________________________________ City: ___________________________________ Country: _____________________ Home Telephone Number: __________________ Fax Number: _________________ E-Mail Address: _____________________ Mobile Phone: _____________________ Address in Qatar (If different from permanent mailing address): P O Box: __________________ City: ________________Country:_______________ Home Telephone Number: _______________ Fax Number: ____________________ Mobile Phone: ________________ Email Address: ___________________________ Educational Data: Name of High School Attended: _____________________________________ Number of Years Completed: _______________ Year of Completion: ____________ State School Independent International Baccalaureate British American Other (please specify) _____________________ Have you done any studies since graduating from High School? Yes No If yes, where___________________________________ ; for how long _________ What is your preferred major? Business Engineering Design Arts Medicine Government/Law Journalism/Communication Other (please specify) _______________ Where do you want to study at University? Education City America How did you learn about the ABP? School Family Friends Britain Other (please specify) _________ ABP Website Radio/TV 2 Newspapers Social Media (Facebook/Twitter) PART II PARENT OR LEGAL GUARDIAN INFORMATION: Full, Legal Name ____________________________________________________ (First) (Second) (Last Name) Relationship: Father Mother Guardian Telephone Number: _____________________ Fax Number: ____________________ Mobile Phone: ____________________ Email Address: _______________________ Signature: ____________________________ Student lives with: Father Mother Guardian Other PART III SPONSORSHIP: If you are admitted to the Academic Bridge Program, your tuition will be paid by: Higher Education Institute Family (Please complete Part IV below) Other : Please specify …………………………………………… PART IV SPONSORS INFORMATION (To be filled by family sponsored students only): 1) Sponsor’s Name: ___________________________________________________ 2) Full Address: _____________________________________________________ Telephone Number: ________________ Fax Number: ________________________ Mobile Phone: ____________________ Email Address: ______________________ 5) Signature: __________________________________ 3 PART V ASSESSMENT/PLACEMENT PROCESS: All applicants must undergo an assessment process that includes an English exam, a writing assessment, a math placement test and a computer placement test. The data collected through these tests will be used to evaluate applicants’ abilities and their commitment to the Academic Bridge Program. Scores on these assessments will determine the level at which students begin the program. Placement testing is a requirement for admission into the Academic Bridge Program. These assessments will be scheduled before the start of the semester. PART VI CERTIFICATION STATEMENT: My signature below indicates that all the information contained in this application is complete and correct. I further affirm that I will meet all my financial obligations and comply with ABP’s regulations. Signature: ________________________________ Date: _______________________ When returning this completed application package, please make sure that the following items are enclosed: Official copy of General Secondary Education Certificate (GSEC) scores Application fee of QR 500 non-refundable Recent passport size photographs (2) Copy of ID card and passport (if applicable) Copy of iBT TOEFL/IELTS scores Submit to: Academic Bridge Program Office of Admissions and Records PO Box 24404 Doha, Qatar Telephone: (+974) 4454 2121 – Reception (+974) 4454 2131 - Admissions Fax: (+974) 4481 9928 Email: [email protected] Our enrollment forms and information will be on the ABP website www.abp.edu.qa DEADLINE : 16th July 2015 4
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