Note: Fields marked with an asterisk * are required
PERSONAL INFORMATION:
Passport Photograph *
Image size must not exceed 2MB
Surname*
First Name*
Middle Name
Gender*
Date of birth *
( YYYY/MM/DD)
Country of Residence*
State of Residence
*
City of Residence *
Occupation *
Contact Phone number(s) *
Contact Email Address *
valid email required for this application process
Computer Litracy & Educational Qualification:
Computer Litracy *
Highest Qualification Obtained *
Admission Information:
Course to which admission is sought*
Study Center (Instructor-led Physical Class)*
Next of Kin's Information:
Next of Kin's must be completed
Next of Kin's Name
Next of Kin's Phone number(s)
Next of Kin's Email Address
Sponsor's Information:
Sponsor's must be completed (if self sponsored, input personal details)
Sponsor's Name
Sponsor's Phone number(s)
Sponsor's Email Address
