Student Application Form – KHOMANANI COLLEGES

Please complete all fields below:

Personal Details

Title *
Surname *
First Name *
Identification No. *
Upload ID. *
Home Language *
Date of Birth *
Gender *
MaleFemale
Marital Status *
Disability *
YesNo
Please Select Your Population Group *

Contact Details

Email *
Confirm Email *
Mobile Number *
Alternative Number *
Physical Address *
Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry
Postal Code *
Postal Address *
Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry

Emergency Contact Person Details

Contact's Name *
Contact Number *
Contact Address *
Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry

School Details

High School *
Do you have a Valid School Leaving Certificate? *
YesNo
National Senior Certificate with Endorsement *
YesNo
Upload your Certificate *

Field of Interest Information

Department *
Programme *
Academic Year *
Semester *

Verification

Please enter any two digits *Example: 12
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