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COVID-19 Survey
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Email
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Your email
Title Name
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Choose
Mr.
Ms.
First Name in English
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Your answer
Last Name in English
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Your answer
Exam Seat Number
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Your answer
1. Which province are you currently living?
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Your answer
2. Did you travel to other provinces since 1 May 2020?
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Yes
No
Which provinces? (If your response is Yes, please specify)
Your answer
When? (If your response is Yes, please specify)
Your answer
3. Are you planning to travel to other provinces in the near future?
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Yes
No
Which provinces? (If your response is Yes, please specify)
Your answer
When? (If your response is Yes, please specify)
Your answer
4. Did you come back from abroad since 1 May 2020?
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Yes
No
Which Country? (If your response is Yes, please specify)
Your answer
When? (If your response is Yes, please specify)
Your answer
5. Are you planning to travel abroad in the near future?
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Yes
No
Which Country? (If your response is Yes, please specify)
Your answer
When? How long? (If your response is Yes, please specify)
Your answer
Consent
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I hereby certify that I have read above statement and the information provided are true and correct, false information or breach of conditions and agreements may lead to be disqualified for MUIC Admissions.
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