Online Course Application

Enter General Details
Campus:* Bank slip No: *
Academic Year:* Intake Code:*
Enter Personal Details
Surname:* Other Names: *
Date of Birth: * Gender
Nationality Mode of Study:
Country of Origin Marital Status
ID Number/Birth cert No:* County
Religion Payment Type
Physical Disability?
Course Choices
First Course Choice:
Second Course Choice:
Residence Status:
Enter Contact Information  
Address: Telephone No. 1:
Postal Code: Telephone No. 2:
Town: Email:
Enter Academic Background Information
Former School Code Examination Body
Date of Admission Examination
Date of Completion* Mean Grade Acquired
Year of Examination * Aggregate Points:
Index Number
Subject Details