Student Application Form
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Programme Details
Programme of Study
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Select Programme
Certificate
Diploma
Advanced Diploma
Bachelor Degree
Postgraduate Diploma
Master Degree
First Choice
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Certificate Program
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Cyber Security
Artificial Intelligence
Others
If any others
Intake
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January
April
July
October
Year
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2024
2025
2026
2027
Mode of Study
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Regular
Evening
Weekend
Term
Blended/E-Learning
ODeL
Personal Details
Title
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Mr.
Ms.
Mrs.
Dr.
First Name
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Surname
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Other Names
Gender
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Select Gender
Male
Female
Other
Date of Birth
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NRC Number
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Postal Address
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Only image files under 1MB are allowed.
Passport Details (For Non-Zambians)
Passport Number
Passport Issue Date
Passport Expiry Date
Nationality
Contact Details
Mobile Number
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Alternate Mobile Number
Email Address
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List all High/Secondary/College/University Attended:
Previous Educational Institute Attended
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Qualification Obtained
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'O' Level or Equivalent Examination Passed and Grades attained in each subject
*
Examination Council of Zambia
Cambridge and London General Certificate of Education
International General Certificate of Secondary Education (IGCSE)
'A' Level Subjects (if applicable)
*
Cambridge International Examination (CIE)
International General Certificate of Secondary Education (IGCSE)
Others
Applicant Form Checklist for Applicants
*
1. Grade 12 Certificate/Equivalent Statement of Results
File must be less than 1MB.
2. National Registration Card / Passport / Driver's License
File must be less than 1MB.
3. Attach two (2) Passport Sized Photo
4. Application form completely filled out accurately
5. Payment for application form attached (Deposit Slip)
File must be less than 1MB.
6. Upload any undergraduate degree certificate
File must be less than 1MB.
Post-Graduate Educational Details (Optional)
Institute/University
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To
Qualification Obtained
Action
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Clarification
Admission Reference Name
Select Admission Reference
DR.MOONO
DIRECT
Others
Upload Signature
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