JAWAZ Card
Non Sponsored Students application Form
   
University/ Institute name * :  Date:
Zone * : DKV / DIAC                          Card Annual Fee: AED 250
     
Title :
Title: Mr. Miss. Mrs.
First Name * Middle Name
Last Name * Nationality *
Country of birth Date of birth *
Passport No * Passport Expiry date *
Passport country of issue *    
Visa number * Visa expiry date *
Visa Status * Sponsored             Non-Sponsored
Marital Status * : Single              Married              Divorced
No of dependents * : 0      1      2      3      4      5
Student type * : Diploma / Certificate        Undergraduate        Post Graduate        Ph.D
Languages spoken * :
Arabic English   Hindi Urdu
Persian Punjabi Melayam Tagal
Russian Sinhala   Others, please specify:
Current Address In UAE *
Emirate * :
Dubai Abu Dhabi   Sharjah Al Ain
Umm Al Quwain Ras-al Khamah Fujeirah Ajman
PO Box / Mailing address Applicant Mobile No *
Applicant e-mail address *
Emergency contact name * Emergency contact relationship *
Emergency contact number *
Level of study * : Year 1        Year 2        Year 3         Year 4
Program of study *
Study type * : Full Time                            Part time
Full time is defined as studying at least 15 hours per week for a minimum of 12 weeks a Year
Expected date of graduation :
Employed * : Yes                  No
Employment type * : Full Time       Part time
Employed at *
Request for Recreation Room Membership * : Yes                No
Recreation Room Membership duration:         0 Month        1 Month          3 Months
                                                                                6 Months      12 Months

Student Disclaimer
In accepting this card I understand and give my consent to the data shown on the front of the card being made
available to ISIC.

This information may only be used by IAS and ISIC to verify the ownership and validity of the card to ISIC benefit providers if
requested. Any other usage of the cardholder data by ISIC is excluded.

I understand and agree that the ISIC benefits provided with this card are only available to eligible full-time students.
Full-time is defined as studying for at least 15 hours per week for a minimum of 12 weeks per year. Proof of student status
will be required and must be provided to TECOM Authority or DIAC- Student Hub for verification.

I agree to be held accountable and liable for any misrepresentation (present or future) of my eligibility for the ISIC benefits.

I understand that in the event of card expiry or if I no longer meet the eligibility criteria for the ISIC benefits that I will be
required to return the card to TECOM Authority or DIAC- Student Hub Department.
Failure to comply with any of the above terms may incur serious penalties and or legal action being taken against me.

I understand that the AED 250 charge for non sponsored students made by TECOM (DIAC) for this card is in relation to administration,
production and card functionality costs and not for the ISIC benefits specifically.

Student Signature  Date:

 
Requirements
1 x Passport Photocopy
1 x Residency page
1 x Color Photograph with white background
This section should be filled, signed and stamped by the university

University Details & Disclaimer
University / Institute name *
Zone * : DKV DIAC
University License No * PRO Mobile No *
e-mail :
Name of authorized signatory *
Please review the form before submission to Dubai International Academic City – Student Hub. By signing below, you take full responsibility for the content of this
form and you attest that the information on this form is free of any errors. In case of any errors, you agree to bear all cost required to rectify any such errors.
Signature & Stamp  Date: