Medical Insurance Registration

Sponsored Students to fill their details in the following form in order to be entitled for medical insurance:



Middle Name:
Last Name:


Civil ID:
Date Of Birth:
Gender: Male Female


Marital Status:
Spouse Name :
Spouse Civil ID:

Children:
1- child name: child civil ID
2- child name: child civil ID
3- child name: child civil ID
4- child name: child civil ID
5- child name: child civil ID
6- child name: child civil ID
7- child name: child civil ID
8- child name: child civil ID
9- child name: child civil ID
10- child name: child civil ID


UK Address
Street:
Postcode:
City:
Mobile:
Email:



University:
Course Start Date:
Expected Graduation Date:
Degree:
Sponsor:
Other:


من لم يلتزم بالتسجيل سيتاخر في حصوله على التأمين الصحي