Full Name

ID Number

Email

Date of Birth

Gender

Nationality

Denomination Name

Full Address

Residence

Marital StatusSingleMarriedWidowedDivorcedSeparatedRegistered partnership

Spousal Name

Who pays your fees if admitted

Name of course you are applying

Diploma

BA Degree

Masters Degree

What is your current employment

Educational background (Please list schools, colleges or universities attended starting with the latest)

Institution

Course

Certificate Obtained

Are you on special medical treatment? if yes, explain

Declaration

I hereby declare and certify to the best of my knowledge that the above information is TRUE and ACCURATE. I further agree to abide to the institutions requirements and regulations.

Applicant's Name

Date

Signature

Attach 2 copies of passport size photo ❌

Attach a copy of ID / Passport ❌

Previous Academic Credentials(You can select multiples) ❌

NB: The institution reserves the rights of admission.