[Translator’s notes appear in square brackets]

[Personal information has been redacted.]



Islamic Republic of Iran

Ministry of Culture and Higher Education

Educational Measurement and Evaluation Organization (EMEO)

In the Name of God

Date: 15/10/[illegible] [05/01]

Number: 11/19424

Enclosure -----

Unit -----

Write the first and second letter of your surname.

First letter S; Second letter A


Sister Pouneh Sabet Sarvestani

We are in receipt of documents to enrol you in academic year 1370-1371 [1991-1992] to participate in the national [university entrance] examination. As stipulated in section 19 it is necessary that you complete the application so that we are able to determine your response to the questions regarding Islamic knowledge (Islamic knowledge or other religions).  You are therefore asked to indicate your religion below by inserting a cross (X) and post your response by 10/12/1370 [29 February 1992] to:  Tehran - Postal Box 15875 - 1314, Educational Measurement and Evaluation Organization (EMEO) - Amendments Section.

In the event that [your response is not received by the specified date] or that you do not provide a response, your application will be cancelled.

1- Islam

2- Christianity

3- [Judaism]

4- Zoroastrian[ism]

[official stamp]

Office of Registration and Educational Affairs

Amendments Section

[handwritten note at the bottom of the page]

In the Name of God

With due respect, I believe in all the holy religions and will sit for the Islamic knowledge examination.

Candidate’s signature: