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The Student Visa Application Form


(Please, fill in English)

Titles of Information






Father's Name


Grandfather's Name( only Arab people)


Date of Birth

(Gregorian Calendar)


Place of Birth




Passport No


Date of Issue

(Gregorian Calendar)


Expiry Date

(Gregorian Calendar)


Place visa to be issued


Duration of Stay in Iran


Last entry to Iran

(Gregorian Calendar)


Note: A copy of passport should be attached


The Address in Iran:  -----------------------------------------------------------------------------------------


The Telephone Number in Iran: (+98)-


The Field of Study:


The Level of Study (Please Mark): 

 BSC                       MSC                                  General Medical Field


 PhD                        Specialty (Residency)        Fellowship          


 Sub-Specialty        Short-term professional Training Program     


Admission Date:

Admission Reference Number:
The Admitting University:

The Date of the Study Begins:


Visa Application form (2)


نام (first name):

نام خانوادگي (last name)

نام پدر (father's name)


نام جد (grandpa's name )

مليت/ تابعيت (nationality)

تاريخ تولد (data of birth)


محل تولد (place of birth)

شغل (your job)

دين (your religion)


قد (height)

رنگ چشم (eye colour)

رنگ مو (hair colour)


شغل پدر (father's job)

شماره گذرنامه (your passport NO)


نام دانشگاه (university name)

شهر محل تحصيل (The city of university)



مقطع تحصيلي (education level)

رشته تحصيلي (your  major)



نيمسال (your entrance semester)

ترم (the semester you are in)


وضعيت تاهل (single or married- marital status)



نام همسر (your spouse's name)

شغل همسر (spouse's job)


تحصيلات همسر (spouse's education)

          شماره گذرنامه همسر (spouse's passport No)

آدرس در كشور خود (your address in your country)


آدرس در ايران (address in IRAN)


شماره تلفن دركشور خود (Your phone No in your country)


شماره تلفن همراه (your mobile No in IRAN)


ايميل (E-mail)






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