Sultan Qaboos University
‫جــامعة الســلطـان قـــابـوس‬
International Cooperation Office
(ICO)
‫مـكـتـب التعاون الدولي‬
2 Passport
Photos
Visitor Researcher's Application Form
Section A: Personal Information
Title:
Dr.
Prof.
Name (as in passport):
Mr.
Ms.
Last
First
Middle
Marital Status:
Married
Single
Date of Birth
(dd/mm/yy)
Gender:
Male
Female
Religion
Passport: No/ ID No:
Date of Expiry
(dd/mm/yy)
Place of Issue
Nationality:
Languages: Native
Place of Birth
Other(s)
Please provide a copy of your C.V.
Contact Address:
House/Street or PO Box _______________________ City/Town _____________________________________
State/Area ____________________ Postal Code _______________ Country _________________________
Telephone: Country Code ____________ Town/Area Code ___________ Number _____________________
Mobile: Country Code ____________ Town/Area Code ____________ Number _________________________
Fax: Country Code ______________ Town/Area Code ___________ Number ___________________________
Email (s): _____________________________________________________________________________
Permanent Home Address (if different from above):
House/Street or PO Box _______________________ City/Town ______________________________________
State/Area _______________ Postal Code _______________ Country _________________________________
Emergency Contact:
Name _______________________________ Relationship _________________________________________
House/Street or PO Box _________________________ City/Town ___________________________________
State/Area ______________ Postal Code _______________ Country ______________________________
Telephone: Country Code ____________ Town/Area Code ___________ Number _____________________
Mobile: Country Code ____________ Town/Area Code ____________ Number _________________________
Fax: Country Code ______________ Town/Area Code ___________ Number ___________________________
Email (s): _____________________________________________________________________________
‫‪Institution‬‬
‫ــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ ‪Institution Name:‬‬
‫‪International Relations Office / Administrative Office‬‬
‫ــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ ‪Name‬‬
‫‪The Director:‬‬
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ ‪Title:‬‬
‫______________________________________ ‪Street or PO Box _______________________ City/Town‬‬
‫_________________________ ‪State/Area ____________________ Postal Code _______________ Country‬‬
‫_______________________ ‪Telephone: Country Code ____________ Town/Area Code ___________ Number‬‬
‫_________________________ ‪Mobile: Country Code ____________ Town/Area Code ____________ Number‬‬
‫___________________________ ‪Fax: Country Code ______________ Town/Area Code ___________ Number‬‬
‫_____________________________________________________________________________ ‪Email (s):‬‬
‫‪Academic Supervisor in Home University:‬‬
‫ــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ ‪Name‬‬
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ ‪Department‬‬
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ ‪Title:‬‬
‫ــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ ‪Position‬‬
‫______________________________________ ‪Street or PO Box _______________________ City/Town‬‬
‫____________________________ ‪State/Area ____________________ Postal Code _______________ Country‬‬
‫_______________________ ‪Telephone: Country Code ____________ Town/Area Code ___________ Number‬‬
‫_________________________ ‪Mobile: Country Code ____________ Town/Area Code ____________ Number‬‬
‫___________________________ ‪Fax: Country Code ______________ Town/Area Code ___________ Number‬‬
‫_____________________________________________________________________________ ‪Email (s):‬‬
‫‪Could you kindly submit an official letter from your supervisor approving your study at SQU.‬‬
‫‪Your Academic Qualification‬‬
‫‪PhD‬‬
‫‪Master degree‬‬
‫‪Bachelor degree‬‬
‫_____________________________________________________________________________ ‪Major:‬‬
‫‪Could you kindly submit a copy of your certificate with this form.‬‬
‫‪Section B: Financial part‬‬
‫‪other‬‬
‫‪An Organization‬‬
‫‪Yourself‬‬
‫‪Your University‬‬
‫?‪Who will finance your visit‬‬
‫ــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ ‪Name of Sponsor:‬‬
‫ــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ ‪Name‬‬
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ ‪Department‬‬
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ ‪Title:‬‬
‫ــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ ‪Position‬‬
‫______________________________________ ‪Street or PO Box _______________________ City/Town‬‬
‫____________________________ ‪State/Area ____________________ Postal Code _______________ Country‬‬
‫_______________________ ‪Telephone: Country Code ____________ Town/Area Code ___________ Number‬‬
‫_________________________ ‪Mobile: Country Code ____________ Town/Area Code ____________ Number‬‬
‫___________________________ ‪Fax: Country Code ______________ Town/Area Code ___________ Number‬‬
‫_____________________________________________________________________________ ‪Email (s):‬‬
‫‪Could you kindly submit an official letter approving the sponsorship.‬‬
‫‪Section C: Research at SQU‬‬
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ ‪Host Unit:‬‬
‫‪Contact Person:‬‬
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ ‪Name‬‬
‫______________________________________ ‪Email (s):‬‬
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ ‪Title:‬‬
‫_________________________ ‪Office extension no.:‬‬
‫_______________________________________________________ ______________ ‪Specific research area‬‬
‫‪Research Proposal:‬‬
‫‪Could you kindly submit your intended research proposal with this form.‬‬
‫‪You are expected to give a seminar upon completion of your research.‬‬
‫‪Intended Period of research:‬‬
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ ‪Duration of research:‬‬
‫___________________________‪Completion Date‬‬
‫________________________‪Start Date‬‬
‫‪Section D: Accommodation‬‬
‫‪On Campus Accommodation‬‬
‫‪No‬‬
‫‪For sabbatical only:‬‬
‫‪Yes‬‬
‫‪Assistance in finding accommodation can be provided for Researcher Visitors. Please contact‬‬
‫‪OEC for further information. Tel: 00968 2414 1978 email: ir@squ.edu.om.‬‬
‫‪Off campus accommodation:‬‬
‫‪Please indicate where you intend to stay in Oman‬‬
‫‪Local address & contact detail:‬‬
‫_________________________ ‪City/Town‬‬
‫_______________ ‪Postal Code‬‬
‫_________________________ ‪Mobile: Number‬‬
‫__________________ ‪PO Box‬‬
‫________________________ ‪Telephone Number‬‬
‫________________________________________ ‪Email (s):‬‬
‫___________________________ ‪Fax Number‬‬
‫‪Accompanying Person(s):‬‬
‫‪Relation to Researcher‬‬
‫‪Name‬‬
‫ــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬
‫ـــــــــــــــــــــــــــــــــ ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬
‫ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬
‫ــــــــــــــــــــ ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ‬
‫‪Please provide relevant certificate if married‬‬
‫‪Official use (SQU):‬‬
‫___________________________ ‪Location:‬‬
‫___________________________ ‪Accommodation type:‬‬
‫___________________________ ‪ext.‬‬
‫‪Contact details:‬‬
‫________________________________________ ‪Name:‬‬
‫‪Stamp‬‬
Section E: Declaration
I, the undersigned, declare that the information provided in my application form is accurate
and complete and maybe rejected if found to be incorrect. I authorize Sultan Qaboos
University (SQU) to make relevant enquiries to verify my application and to provide the
necessary information to partner institutions for the purpose of arranging my visit.
I also acknowledge that I will conform to SQU and societal rules and regulations.
Furthermore, I fully understand the following:

Protection of SQU property is everyone's responsibility. I am liable for any damage I
cause to SQU property.

I will be fully responsible for payment of the accommodation charges and utility bills
whether it is arranged by SQU or by myself (bench fees, visas if applicable)

I am aware that SQU or any of its affiliates cannot be held responsible for any accidents
that may occur during working hours or in my free time.

SQU may take the necessary actions including termination of my visit if I breach its
regulations.

I am insured against illness, accidents including repatriation in case of illness, accidents
or death during my stay in Oman.

I will keep my SQU contact fully informed about my progress, including a draft work
before publishing, and submit two copies of the publication (if any) produced during my
affiliation with SQU.

I have read and will abide by the Research visitor's obligations.
Insurance Co. _____________________________________ Receipt/Policy No _________________
Please send a copy of the insurance policy, if any. Otherwise, send it after the SQU approval.
Full name: _______________________________________________________
Signature:_______________________________
Date
(dd/mm/yy)
Official use (sign & stamp) (SQU)
Approved: ________________________________ Not approved: __________________________________