APPLICATION FORM

APPLICATION FORM
Name *

Prefix First Name Middle Name Last Name
Gender *
Phone Number *
Alternate Phone Number
ID/PASSPORT NO *
Date of Birth *

Month Day Year
Email
example@example.com
Address *

Street Address

Street Address Line 2

City

Zip Code Country
Mode of Study
Mode of Study *
Programme *

Higher Certificate Information Technology End-User Computing Android Mobile App Development Search Engine Optimization (SEO) Website Development Cloud Computing (Networking) Ethical Hacking Graphic Design Robotics Radio Presenter Master Class
Next of Kin Details
Name *

Prefix First Name Middle Name Last Name
Email
example@example.com
Phone Number *
Address *

Street Address

Street Address Line 2

City Province

Postal / Zip Code Country
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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