Student Registration form

ADMISSION FORM

Please read the information carefully before filling in this form, and ensure you have understood all clauses on the attached Students college's Rules and Regulations

Personal Information

First name

Middle name

Last name

ID Number

ID
Number

Date of
birth

Birth place

Marital
status

Occupation

Your
Gender

Religion

Telephone
number

Confirm Telephone
number

Nearby
town

Country

Next of kin

Father

Telephone

Mother

Telephone

Guardian

Telephone

Who Pays your fees?(Tick & Fill appropriately)

Self Parent Guardian Sponsor

Name

Telephone

Education Background

Secondary school attended

From Year

To year:

Grade attained

Other College Attended (if any)

From Year

To year:

Course Application

Course name

Course Level

Start month

Mode of study

Other details

We would like to hear from you

How did you get to know Topmax College? (Tick as appropriate)

Relatives Friends Colleague Topmax Website

Health status

Do you suffer from any health condition?

Yes No

If yes, describe your condition below

Do you reside at our hostels?

Yes No

If referred by Topmax College student, give full names and course

Name

Course

Phone

Admission number

Complete & Submit

I declare that the information given in this registration form is true and correct to the best of my knowledge, I further certify that i have read, understood and agreed to comply with the terms and conditions of admission.

Date

Customer care agent

Signature:Kindly when reporting request for your form to sign

Admission letter	Number of terms	Mode of study
Course outline	Practical fees	Practical requirements
Course fee structure	Exam body	External exam fee structure
Tablets offer	Free computer course	Attachment offer
Student information manual