APPLICATION FORM

APPLICATION FORM
Name*

PrefixFirst NameMiddle NameLast Name
Gender*
Phone Number*
Alternate Phone Number
ID/PASSPORT NO*
Date of Birth*

MonthDayYear
Email
example@example.com
Address*

Street Address

Street Address Line 2

CityState

Zip CodeCountry
Mode of Study
Mode of Study *
Programme*

Higher Certificate Information TechnologyEnd-User ComputingRobotics for kidsRoboticsGraphic DesignAndroid Mobile App DevelopmentSearch Engine Optimization (SEO)Website DevelopmentCloud Computing (Networking)Ethical HackingRadio Presenter Master Class
Next of Kin Details
Name*

PrefixFirst NameMiddle NameLast Name
Email
example@example.com
Phone Number*
Address*

Street Address

Street Address Line 2

CityProvince

Postal / Zip CodeCountry
DECLARATION BY THE CANDIDATE

I certify that all information provided in the application is accurate. I agree to familiarize myself with all the rules and regulations of the program set forth by the Africa School of Technology and abide by them. I would uplift the standards and respect the principles of Africa School of Technology as an organization of higher learning.
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