Acceptance form

1- Read the form very carefully and then complete it.

2. Pay attention to your daily schedule and make sure that the workshop dates do not interfere with your personal plans.

3. Do attend all sessions in time.

"Note that if you are filling out the form with the mobile phone, you will need to insert your phone keyboard numbers in ENG mode.

First Name  *
Surname  *
Gender  *
National ID Number  *
Date of Birth  *
Date Format (MM/DD/YYYY)
Family and Marital Status  *
National ID card Image
Education / Degrees  *
Subject Area  *
Major  *
Please avoid filling the blank with “self-employed”, and mention your occupation specifically.  *
Occupation  *
Home Number  *
Cell Phone Number  *
Email Address  
References  *
Reference’s Phone Number  *
Your Relation to the Reference  *
Place of Residence
Country  *
City  *
Address  *
Kindly describe what you have heard or seen from your reference so that you are inclined to participate in the Life Skills Workshop.  *
Are you currently receiving any special medication or treatment?  *
Are you under a psychiatrist’s or psychologist’s supervision?  *
Illness  *
Physician’s Name  *
Physician’s Specialization  *
Medication Name  *

Obur Workshop tuition: 40,000,000 Rials

Please note that attending the Acceptance Session and meeting other requirements for the Life Skills Workshop does not indicate your definite registration.

I apply to participate in  *