Online Registration First Name Middle Name Last Name Gender Gender Male Female Date of Birth Address Phone Your primary contact number Email Interests or Hobbies Do you have a valid Passport? Do you have a valid Passport? Yes No Passport Number Issue Date Valid Till Issued by Services Needed Services Needed University Placement Service (Admission processes only) Visa Application Service Emigration Service All services other: Name of Institution Completed Enter your SHS information or last tertiary institution completed Institution Address Institution telephone Institution fax Institution Email Address Program Studied Examination Passed Year of Passing Phone Numbers Sponsor's Full Name Sponsor's Email Interested Program Interested Program General Medicine Dentistry Pharmacy Nursing (Degree) Nursing (Diploma) Engineering other: Please Select Year of Planned Entry 2021 2022 2023 Please select the year you plan to enter into the university Type of Program Type of Program Undergraduate (degree) Postgraduate (Ph.D) other: Please Select How did you hear about us? How did you hear about us? Facebook Whatsapp SMS Radio Tv Word of Mouth: other: Please select how you heard about us. If you were refered by someone, kindly enter the name. The above information is true to the best of my knowledge The above information is true to the best of my knowledge yes no Security Question 4 × 2 = ?
