APPLICATION FOR UNIVERSITY PLACEMENT ABROAD
Please fill all fields.
Level of Study:
Program of Study:
Country of Study:
PERSONAL INFORMATION
Family Name:
First Name:
Middle Name:
Permanent Address :
Region (GH)
City/Country:
Telephone:
Mobile:
Res. Country:
E-mail:
Do you smoke?
Driving Licence?
- If Yes, No#:
EMERGENCY/ALTERNATIVE CONTACT
Name:
Telephone:
City/Country:
Relation:
Date of Birth:
City of Birth:
Country of Birth:
Nationality:
Sex:
Marital Status :
Passport No#:
Country of Issue:
Expiry Date:
EDUCATIONAL BACKGROUND
Presently a full-time student?
Expected Year of Graduation:
Languages Spoken:
Hobbies/Interests:
Computer Literate?
TRAVEL EXPERIENCE
Have you ever travelled outside your home country before?
- If yes give details:
HEALTH STATUS
Do you have any allergies or health problems that will affect your ability to work?
Are you currently under the care of a physician for a long-term or permanent condition?
-If yes, list conditions
Do you have any condition that may hinder you from standing on your feet for a long time, working long hours or lifting large or heavy objects?
   
I have read and understood the application, I understand that I may only receive one job offer, and that failure to accept the terms of this offer without a valid explanation may lead to my cancellation from the programme.

I also swear under the penalty of perjury that the above information is true to the best of my knowledge and beleive. Any false statements in this application will result in the termination of my programme with no refund.
Date:
   
 
   
   
AFFILIATES
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