Short Course Application

Apply for a Short Course

First Name

First name is required

Last Name

Last name is required

Valid email is required

Phone Number

Phone number is required

Date of Birth

Date of birth is required

Gender

Gender is required

Nationality

Address

National Registration Card Number

Grade 12 Certificate (Optional)

National Registration Card (Mandatory)

Select Course

Course selection is required

Select Intake

Intake selection is required