Application Form

First Name:

Surname:

Date of Birth:

Gender:

Marital Status:

Email Address:

Phone Number:

Home Address:

District:

T/A:

Village:

Religious Affiliation:

If not catholic, Specify

Secondary Attended:

Secondary Completion Year:

Any Disability?:

If Yes State The Nature:

First Name:

Surname:

Email Address:

Phone Number:

Relationship With Guardian:

Program of Study:

Subjects Passed on MSCE Certificate

Financial Support:

Other Specify:

Upload copy of original certificate or notification (MSCE) or any other:

Upload copy of academic transcript (Upgrading Candidates):

Upload copy of practicing License (Upgrading Candidates):

Upload Proof of payment of the application fee (bank deposit slip):

Upload Photographic Identity:

Upload letter from Sponsor:

Please check carefully to ensure you have attached the following:

Copy of MSCE certificate(s) or its equivalent (i.e., notification of results slip)
Copy of academic transcript of results (upgrading candidates)
Copy of practicing license (upgrading candidates)
Photographic identity card
Proof of payment of the application fee (bank deposit slip)
Proof of ability to pay fees (i.e., either by attaching a letter from the sponsor or employer confirming sponsorship or bank statements)

Failure to provide the relevant and necessary information and/or documents may risk disqualification of the entire application.

I certify that the information I have given is true and that I have checked and provided all the relevant information and documents required.

STUDENT APPLICATION FORM