Course Application Form

Personal Information

Title
Full Name
Marital Status
Gender
Nationality
ID Card No. / Passport No.
ID Expiry Date
Date of birth
Contact No.
Alternate contact No.
Email
Highest Qualification
Present Address
House / Apartment / Unit
Road
Atoll
Island
Permanent Address
House / Apartment / Unit
Road
Atoll
Island
Disability

Are you a person with a disability? Disability includes sensory, physical, intellectual, learning or immunological disabilities; physical impairment, mental health or chronic medical condition. Disability may be episodic or intermittent.

Course Information

Intake
Preferred course
Alternate course

Emergency Contact

Full Name
ID Card No. / Passport No.
Contact No.
Relationship with the applicant
Present Address
House / Apartment / Unit
Road
Atoll
Island

Financing

Financing Option

Referral Source

Referral Source

Declaration

Copy of ID card
Copies of GCE A/L, GCE O/L, HSC and SSC certificates
Accredited copies of academic certificates and transcripts
Work experience letters (if required)
Letter of sponsorship (if sponsored)
Other Documents (if required)

Note: Forms which are incorrectly completed will delay the decision making process. All applicants must carefully review the completed form, in particular checking that all required information has been completed in full, with Academic Reference attached, before sending the form back to Zikura International College.

Zikura International College