SN: 000B11

RADFORD UNIVERSITY COLLEGE

Please fill in this application Form using CAPITAL LETTERS

Application for Admission To Undergraduate Programme

Fix Photograph Here Please write your name and proposed programme at the back of the photo

Academic Year
Do not write in these boxes (for official use only)

SECTION A
Mr Mrs Ms Miss Rev

PERSONAL DETAILS
Surname First Name

(Tick appropriate box) Other Names (if any):

Gender: Male

Female

Day Month Date of Birth: (Tick appropriate box) Nationality:

Year

Age(on your last birthday):

Place of Birth:
Tel:

Are You Permanently Resident in Ghana? (Please tick the appropriate box) Residential Address:

Yes No

Passport No: Email:

Postal Address:

Identification
Voters ID No: National ID No: Social Security No:

SECTION C
(Please fill the below information)

EDUCATION AND QUALIFICATION

School / Institution / College

From

Dates
To Level

Qualification
Subjects Grades

Date Obtained

SECTION C

PROGRAMMES OF STUDY

Please indicate the programme you are interested in pursuing at Radford and the session for which you are applying

PROGRAMME
Tick 1 2 3 4 5 6 BA(Hons) Fashion Design BA(Hons) Graphic Design BSc Information Communication Technology (ICT) BSc Business Administration BSc Applied Science BSc Allied Health
Full Time (Day)

SESSION
Full Time (Evening) Full Time (Weekend)

SECTION D
Full Name: Mr./Mrs./Ms./Miss/Rev/ Other(please specify) Relationship to Applicant:

SPONSOR / GUARDIAN DETAILS

Tel: Email:

Mobile:

Occupation:

Fax:

SECTION E One (1) Completed Application Forms

CHECKLIST

Two (2) Recent Passport-size Photos (must be endorsed with the signature of a referee) Certified Copies of Results/Qualification/certificate Copy of Passport (Foreign Applicants Only) Copy of Birth Certificate (Mature Students) SECTION F DECLARATION

The information on this form is the correct and honest data about .......................... I understand that any offer of a place to the application as an undergraduate student will be based upon the information given on this form, and that if I am found to have given false information, the offer may be withdrawn. I understand that the information supplied on this form will be retained by the University and will be used for the purpose of processing the application. If the application is accepted the information will form part of the permanent student records. Name of Applicant Signature Date Name of Sponsor/Guardian Signature Stamp Date