WEB INFO-NET STUDENT APPLICATION FORM

Please be certain you have chosen the right course as listed bellow before you continue:

Course chosen: /=

Applicant's Details:
Full Name: *

Gender: * Male     Female                     Nationality: *

Email: *                 Tel: *

Postal / Residential Address: *

University / Institution: *

Person to be contacted in case of emergency. (Name, Telephone, eMail): *

Details of emmergency contact listed above(Physical Address, Occupation and Relationship to the applicant): *

Is there additional information you would like us to know with regards to your participation in the Institute?: *

Please attach a passport size photo to allow us prepare a student Id for you: *