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Uyghur Academy Membership Application Form

Section One: Personal Information

First Name*

Middle Name

Last Name*

Place of Birth*

Citizenship*

Work Place*

Occupation*

Email*

Phone

Confirm Email*

Membership Type

Optional: Contact Address

Street Name

Apt or Suite Number

City

State or Province

Zipcode (Postal Code)

Country

Section Two: Education History

(List of schools you have attended - Bachelor Degree or above. You can add up to three academic institutions)

University/College One

University Name*

Academic Major*

Academic Degree*

Start Date*

Graduation Date*

Univeristy/College Two

University Name

Academic Major

Academic Degree

Start Date

Graduation Date

University/College Three

University Name

Academic Major

Academic Degree

Start Date

Graduation Date

Upload Resume*

Signature*

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