Student Registration

REGISTRATION

Please Fill in Capital Letters

Full Name

Date of Birth

Place of Birth

Full Address

Nationality

State of Origin

Sex

Phone Number

Marital Status

Email

Program Type

Department

Education

Please attach copies of certificates

Institution, City & Country

Dates From - To

Certificate Upload

Please attach copies of certificates

Institution, City & Country

Dates From - To

Certificate Upload

Please attach copies of certificates

Institution, City & Country

Dates From - To

Certificate Upload

DECLARATION

I certify that the statements made by me on this form are true and correct. Any false statements may disqualify me.

Date

Applicant Signature