Application Form – SSRUIC e-Learning

Application Form International College,
Suan Sunandha Rajabhat University
申请表泰国萱素南他皇家大学国际学院

Surname (姓) (required) *

First Name (s) (名) (required) *

Home Address (家庭住址)

Telephone number (电话号码) (required) *

E-mail (邮箱) (required) *

Date of Birth (出生日期) (required) *

Place of Birth (出生地)

Nationality (国籍) (required) *

Sex (性别) (required) *
MaleFemale

Parent or Guardian Information (父母或监护人信息)

Family name and initials (姓及姓名首字母大写)

Address (地址)

Country (国家)

Telephone no. (电话号码)

I state that all information supplied is completely accurate, and that I have ENCLOSED THE ABOVE STATED SUPPLEMENTS.
(我声明所提供的所有信息完全准确，并且我已经附上了综上所述的材料。)

Date (日期)

Place (地点)

Signature (签字)

1 Copy of the Passport (护照复印件一份)

1 Copy of educational background (教育背景复印件一份)

International College, Suan Sunandha Rajabhat University.
111/5 Moo2, Tumbon Klongyong Amphur Phuttamonthon, Nakhon Pathom 73170, Thailand.
WWW.SSRUIC.SSRU.AC.TH, WWW.PR.SSRUIC.SSRU.AC.TH
E-mail (邮箱)： SSRUIC@SSRU.AC.TH

Please attach: 1 copy of the passport. 1 Copy of educational background.
(请附上：护照复印件一份；教育背景复印件一份)