APPLICATION FORM
1. COURSE ENROLLMENT
NAME OF COURSE CLASS
1. Weekday Weekend Evening Online
*Tick where applicable
2. Weekday Weekend Evening Online
*Tick where applicable
N.B Please note that evening and online classes are subject to the course you take.
2. PERSONAL INFORMATION
SURNAME: …………………………………………………………… NAME(S): ………………………………………………………………………………
D.O.B: …………………………………………………. NATIONAL I.D: …………………………………………………………………………………………
NATIONALITY …………………………………………………………. GENDER:
CELL NUMBER: ……………………………………………………….. *(PREFERABLY WHATSAPP)
EMAIL ADDRESS: ………………………………………………………………………………………………………………. *(FILL IN AS IT IS WRITTEN)
HOME ADDRESS:……………………………………………………………………………………………………………………………………….
…………………………………………………………………………………………………………………………………………………..
3. ACADEMIC QUALIFICATION
EXAMINATION BODY LEVEL (e.g O, A, NC,ND, SUBJECT/COURSE GRADE
(e.g ZIMSEC/CAMBRIDGE) HND)
I DECLARE THAT THE INFORMATION I HAVE GIVEN IS CORRECT AND THAT SHOULD IT BE FOUND TO BE FALSE MY
APPLICATION WILL BE DISCUSSED AND I WILL FACE LEGAL ACTION.
SIGNATURE OF APPLICANT: ……………………………………………………………… DATE: …………………………………………
N.B. To this form, attach certified copies of the following document
1. Birth Certificate 3. Academic Certificates
2. National ID 4. Marriage Certificate ( if applicable
How Did you hear about Us? (Tick where Appropriate)
Referral Facebook WhatsApp Google Other