Please download and fill in this application form then email your filled copy mccak@ymail.com.We will contact you with details of your admission.

 

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Other Names*
 
 
 
 
 
 
 
 
Salutation*
 
 
 
 
 
 
Email Address*
 
 
 
 
 
 
 
 
Mobile Number*
 
 
 
 
 
 
Date of Birth*
 
 
 
 
 
 
 
 
 
 
District of Origin*
 
 
 
 
 
 
Gender*
 
 
 
 
 
 
 
 
Religion*
 
 
 
 
 
 
Nationality*
 
 
 
 
 
 
 
 
Marital Status*
 
 
 
 
 
 
National ID Number*
 
 
 
 
 
 
 
 
Place of Residence*
 
 
 
 
 
 
 
District of Birth*
 
 
 
 
 
 
 
 

Address

 
 
Permanent Address*
 
 
 
Village*
 
 
 
 
 
 
 
 
 
 
 
Sub County/ Constituency*
 
 
 
 
 
 
 
 
 
 
 
District/State*
 
 
 
 
 
 
 
 

Next of Kin (contact Details)

 
 
Name*
 
 
 
 
 
 
Relationship*
 
 
 
 
 
 
 
 
Mobile No*
 
 
 
 
 
 
Email*
 
 
 
 
 
 
 
 
Address*
 
 
 
 
 
 
 
 
 
 
 

Disabilities (if any)

 
Any physical or other disability that you would want to bring to the attention of the University authorities
 
 
Disability*
 
 
 
 
 
 
 
 
 
 
 
 

PLE Information

 
 
 
 
PLE Index No.*
 
 
 
 
 
 
 
 
 
 
Year of Sitting
 
 
 
 
 
 
 
 
 
 
PLE School*
 
 
 
 
 
 
 
 
Subject Name*
 
 
 
 
 
Grade obtained*
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

PLE Grade Information

 
 
Distinctions
 
 
 
Credits
 
 
 
Passes
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

O-Level Information

 
 
 
 
O-Level Index No.*
 
 
 
 
 
 
 
 
 
 
Year of Sitting*
 
 
 
 
 
 
 
 
 
 
O-Level School*
 
 
 
 
 
 
 
 
Subject Name*
 
 
 
 
 
Grade obtained*
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

O-Level Information

 
 
Distinctions
 
 
 
Credits
 
 
 
Passes
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

A-Level Information

 
 
 
 
A-Level Index No.*
 
 
 
 
 
 
 
 
 
 
Year of Sitting*
 
 
 
 
 
 
 
 
 
 
A-Level School*
 
 
 
 
 
 
 
 
Principle Subjects*
 
 
 
Subject name*
 
 
 
Grade obtained*
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Program Choices

 
Please select the program(s) you want to be admitted to. Priority is made from the first choice. You will make 3 Choices.
 

Choice 1*

 
 
Programs*
 
 
 
 
 
Campus
 
 
 
Study Time
 
 
 
Entry Study Year
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Choice 2*

 
 
Programs*
 
 

Choice 3*

 
Programs*
 
 
 

Other Qualifications (Degree, Diploma, Certificate e.t.c)

 
Any qualifications you enter here will be required to be presented in hard form, when you come to the institution to pick your admission letter, Provide the most relevant 4 qualifications which may assist us in admitting you to the programs of your choice.
 
 
Institution
 
 
 
Award
 
 
 
Duration
 
 
 
Awarding Body
 
 
 
Entry Study Year
 
Grade
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Upload Academic Documents (All documents must be well scanned and clear to read) *
 
 
 
 

List some of the areas you have worked before and attach documents if any i.e. professional, references, e.t.c

 
 
Company Name
 
 
 
Role/ Position Held
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Referee Name
 
 
 
Contact Details
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
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