STUDENT APPLICATION This form is the first step in the enrollment process to attend one or many of the courses as offered by Giligia College. After this form is filled-out and submitted a confirming email will be sent to the applicants email inbox. Giligia College will then contact you by telephone or email to discuss further steps toward the enrollment, class schedules and requirements. Subject Interest Medical Billing & Coding System Administrator/ Administrative Assistant Taxation Vocational English as a Second Language Focusd on Medical Billing & Coding Website Design & Programming First Name Middle Name Last Name Government/ State Identification Number Street Address City State and Zip Code Country CONTACT Information: Email Address Other Personal Information: Date of Birth Nationality Afghanistan Albania Algeria Andorra Angola Antigua and Barbuda Argentina Armenia Australia Austria Austrian Empire Azerbaijan Baden* Bahamas, The Bahrain Bangladesh Barbados Bavaria* Belarus Belgium Belize Benin (Dahomey) Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Brunswick and Lüneburg Bulgaria Burkina Faso (Upper Volta) Burma Burundi Cabo Verde Cambodia Cameroon Canada Cayman Islands, The Central African Republic Central American Federation* Chad Chile China Colombia Comoros Congo Free State, The Costa Rica Cote d’Ivoire (Ivory Coast) Croatia Cuba Cyprus Czechia Czechoslovakia Democratic Republic of the Congo Denmark Djibouti Dominica Dominican Republic Duchy of Parma, The* East Germany (German Democratic Republic) Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Eswatini Ethiopia Federal Government of Germany (1848-49)* Fiji Finland France Gabon Gambia, The Georgia Germany Ghana Grand Duchy of Tuscany, The* Greece Grenada Guatemala Guinea Guinea-Bissau Guyana Haiti Hanover* Hanseatic Republics* Hawaii* Hesse* Holy See Honduras Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kingdom of Serbia/Yugoslavia* Kiribati Korea Kosovo Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Lew Chew (Loochoo)* Liberia Libya Liechtenstein Lithuania Luxembourg Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Mauritania Mauritius Mecklenburg-Schwerin* Mecklenburg-Strelitz* Mexico Micronesia Moldova Monaco Mongolia Montenegro Morocco Mozambique Namibia Nassau* Nauru Nepal Netherlands, The New Zealand Nicaragua Niger Nigeria North German Confederation* North German Union* North Macedonia Norway Oldenburg* Oman Orange Free State* Pakistan Palau Panama Papal States* Papua New Guinea Paraguay Peru Philippines Piedmont-Sardinia* Poland Portugal Qatar Republic of Genoa* Republic of Korea (South Korea) Republic of the Congo Romania Russia Rwanda Saint Kitts and Nevis Saint Lucia Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Schaumburg-Lippe* Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands, The Somalia South Africa South Sudan Spain Sri Lanka Sudan Suriname Sweden Switzerland Syria Tajikistan Tanzania Texas* Thailand Timor-Leste Togo Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Tuvalu Two Sicilies* Uganda Ukraine Union of Soviet Socialist Republics* United Arab Emirates, The United Kingdom, The Uruguay Uzbekistan Vanuatu Venezuela Vietnam Württemberg* Yemen Zambia Zimbabwe Citizenship Status Yes No Highest Education Level Grammar School High School Associate Degree Bachelor Degree PHD Marital Status Single Married SUBMIT