signing a form


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I need to sign a few forms regarding my master scholarship for which I have applied and I need your help to shed some light on a certain issue.

 

At the end of a form, after I input my name and country, I am supposed to sign the document but it states:

 

 

Done at......................................on........................................ 

 

I am confused about the prepositions used in the above sentence.

What am I supposed to write after 'Done at'? Is it my current city?

What should I write after 'on'? The date?

 

Please, help me out.

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Here, documents (or any kind of official request) use the city followed by the date. If the form requires your name and country, "At" seems to point to city as well.

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