Tashkent State Agrarian University Nukus branch
Deputy Director for Training and Education
Faculty specialty, course, name, surname written
Through this application I would like to inform you that I live in a remote area (province) and have no relatives in Nukus, I have 2 groups of disability, so I ask for a place in the dormitory to facilitate my coming to study.
Applicant ______ name and surname date 20___ year