Entry Requirements

Name *

First

Last

Religion

Sex *

Date of Birth (DD-MMM-YYY) *

Age *

Place of Origin *

Country *

Nationality *

Home District *

Town *

Sub County *

Village *

Marital Status *

Relationship: Father/Mother/ others specify *

His/her Names *

Occupation/Profession *

Physical Address *

Postal Address

Telephone Contacts *

Email

Next of Kin Name (Mr./Mrs./DR) *

Postal Address

Relationship *

Telephone

E-mail *

How did you come to know about us

Uganda Certificate of Education/Equivalent *

Examining Authority *

Name and Address of the School *

Year of Examination *

Index Number *

Subjects (Provide Grade/Marks in figures (S.6)(not pass, Credit, distinction)) *

ANY OTHER QUALIFICATIONS (University/Institute/Collage) Provide Addresses and Certified photocopies must be attached to the application form

PERSONAL STATEMENT: Provide a short statementindicating why you wish to undertake this course(your first preference) *