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SCB Application Form 2024

This document contains a standard application form for Kwame Nkrumah University of Science and Technology for the 2023/2024 academic year. The form collects personal information from applicants such as name, date of birth, contact details, program of study, and parents'/guardian details. Applicants must also provide residential addresses and declare that the information given is true and accurate by signing the form. A referee from the university must also provide their details and sign the form.

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Mike Ross
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135 views2 pages

SCB Application Form 2024

This document contains a standard application form for Kwame Nkrumah University of Science and Technology for the 2023/2024 academic year. The form collects personal information from applicants such as name, date of birth, contact details, program of study, and parents'/guardian details. Applicants must also provide residential addresses and declare that the information given is true and accurate by signing the form. A referee from the university must also provide their details and sign the form.

Uploaded by

Mike Ross
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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KWAME NKRUMAH UNIVERSITY OF SCIENCE AND TECHNOLOGY

2023/2024

STANDARD CHARTERED APPLICATION FORM

PART 1. APPLICANT`S INFORMATION

1. a) Surname b) First Name c) Other Name(s)

2. Date of Birth (dd/mm/yy) 3.Gender 4.Reference Number 5. Index Number

Male: Female:

6. a) Place of Birth/Region(e.g. Kumasi- b) Residential Address 7.Nationality


Ashanti Region):

8. Religion/Religious group name (e.g. 9. Hall of Affiliation 10. Student Vodafone # 11. Other Mobile #
Christianity/ Pentecost Church)

12. Programme of Study 13. Duration of Programme 14. Wassce Aggregate


(If applicable)

15. College 16. Faculty 17. Department 18. Year/Level

19. Indicate the mode by which you gained admission to the University.
a) Less Endowed Student b) Parallel Student c) Fee-Paying Student d) Regular Student e) Other

20. Residential Address when school is 21. Are you a beneficiary of any 22. If Yes state Source
in session. scholarship/bursary? Source:
YES NO
Award Date:
Amount:

PART 2. PARENTS’/ GUARDIAN INFORMATION

FATHER Check the box if Deceased MOTHER Check the box if Deceased
1. Name 1. Name

2. Marital a) Single b) Married c) Separated/Divorced 2. Marital Status a) Single b) Married c) Separated/Divorced


Status

3. Residential Address 4. Mobile # 3. Residential Address 4. Mobile #

1
5. Number of Children 5. Number of Children

6. Occupation 7.Unemployed 6. Occupation 7.Unemployed

8. Name and Address of Employer 8. Name and Address of Employer

PART 3. STUDENT’S DECLARATION

I hereby declare that the information given by me is True and Accurate.

Applicant’s Name Applicant’s Signature Date

………………………………………………… …………….…………………………………. ………………………………

PART 4. NAME AND ADDRESS OF REFEREE

Please provide details of one referee. He/she MUST be a Senior Member of the University.

REFEREE

Name Position

Address Date

Signature & Stamp

…………………………..

PART 5. FOR OFFICIAL USE ONLY

COMMENT
………………………………………………………………………………………………………………………………………………………………………………………
……………………………………………………………………………………………………………………………………………………………………………………….
…………………………………………………………………………………………………………………………………………………………………………………….…
………………………………………………………………………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………………………

NAME

……………………………………………………………………………………………………………………………………………………………………………

SIGNATURE ………………………………………………….. DATE ………………………………………………….

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