Gender*

-Select- ប្រុស ស្រី

Date of Birth*

Nationality*

-Select- Cambodian England

How do you know Angkor University *

-Select- Highschool Visit Facebook Telegram TikTok Youtube other

Preferred Phone*

Alternative Phone

Email*

Parent / Guardian Name *

Phone *

Email

Current or most recent Secondary / High Schools *

Graduation / Exit Date *

-Select- 2023 2022 2021 2020 2019 2018 2017 2016

Please list any other Secondary / High Schools :

Graduation / Exit Date :

-Select- 2023 2022 2021 2020 2019 2018 2017 2016

Please explain in 1 or 2 sentences the reasons for which you want to study towards the Bachelor of Midwifery.

I will try my best to support Angkor University and other students.

I declare that the information given in this form is true and correct, and if accepted as a student, I will comply with all the conditions, rules and regulations of the institute including the rules and code of conduct in the Student Rulebook | Policy.

I have read, understood, and accepted all above statements.