SUPREME TECHNO GLOBAL UNIVARSITY

A. List all research works that you have conducted or participated (type, purpose, subject matter, descriptions, institution where it was conducted, supervisor and whether it was published; provide title, publisher and date if possible).

B. List the publishers and dates of books, monographs, or pamphlets published (use separate paper if necessary)

C. List the titles of articles (Journals and dates) published or unpublished (use separate paper is necessary)

D. List recent seminars, medical meetings, symposiums, and conferences attended:

E. List awards and honors received:

Have you ever applied to this organization for admission into any of it’s programs at any time?

Yes
No

Languages spoken or written:

English French Spanish Arabic Other

I certify that I voluntarily enrol and willingly support the concept of Continuing Education Programs.. I understand that no action will be taken on my application without submitting all the required credentials. I authorize full investigation of my application. Clicking the SUBMIT button, is the authorization to anyone to release any information you may request on me. I agree to indemnify, release and hold harmless STGU and its Agents from any liabilities or torts by reason of their acts or omissions in connection with this application. I agree to abide by the decision of STGU and its Agents from any liabilities or torts by reason of their acts or omissions in or its agents. I agree to function within the limits of my competency and I guarantee and warrant that STGU and its Agents from any liabilities or torts by reason of their acts or omissions in (and its agents) assume no responsibility for any of my activities or actions.

It is understood by me that any falsification of records, misrepresentation of material facts, dishonesty, forgery, and unethical practices will automatically render any certifications awarded to me NULL and Void. Under penalty of perjury, I guarantee and warrant that all information provided on all pages of this application are true and correct. I am legally bound by the foregoing as attested to here with my signature below.

Name:

Permanent Address:

Address for Communication, if different from above:

This application is for

CHOOSE ONE

CHOOSE ONE (All certificates come with grade sheets)

OR

Provide details of the course that you are applying for (Mention the University / Institution name)

List all educational institutions attended since Secondary or High School, including professional schools and certificates,
diplomas and degrees obtained.

With the completed application, I am enclosing the following required document (for initial processing) with my application

1 ) Copy of professional degree, certificates or diploma;

2 ) A detailed curriculum vitae or bio data;

3 ) Passport sized photo with name and signature on back;

Research and Publications (use separate paper if necessary)

I have read and understood the disclaimer provided.