Student Agreement Acknowledgement Form
Please fill in this form to complete your enrolment process. The details of your student records and your agreement acknowledgement will be submitted to the Government of Dubai's Knowledge and Human Development Authority on receipt of your response.
Student ID (MISIS No)
*
M0XXXXXX
Year of study
*
Please Select
IFP
Undergraduate - Year 1
Undergraduate - Year 2
Undergraduate - Year 3
Postgraduate - Year 1
Cohort
Your Name (as per passport)
*
Nationality
*
Passport Number
*
Date of Birth
*
-
Day
-
Month
Year
Date
MDX University Student Email
*
AG1234@live.mdx.ac.uk
Programme
*
Emirate listed as Place of Issue on your Emirates ID
*
Please Select
Abu Dhabi
Dubai
Sharjah
Ajman
Ras Al Khaimah
Fujairah
Umm Al Quwain
Outside UAE
Others
Do you have an Emirates ID
*
Yes
No (Under Processing)
Acknowledgement
*
I hereby acknowledge that I will re-submit the KHDA Student Agreement form once I obtain my Emirates ID promptly upon receiving it.
Are you under Middlesex University Student Visa?
*
Yes
No
Your Emirates ID number
*
Sample without dashes - 7842024123451
Student's Mobile Number UAE
*
Enter Country code e.g. +971 55555555
Emergency Contact's Name
*
Relationship with emergency contact
*
Parent
Brother/Sister
Relative
Spouse
Other
Emergency contact number
*
include country code e.g. +971
Emergency contact's email ID
*
Upload a copy of your current passport
*
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Upload a copy of your EMIRATES ID
*
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Upload a copy of your VISA
*
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Please sign here
*
Submit
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