FORM A
INTERNATIONAL UNIVERSITY, BAMENDA
Application No.
00030107
I B
U
REPUBLIC OF CAMEROON
CENTRAL AFRICA Fix Picture Here
P.O.BOX 444, BAMENDA
Motto: Service to mankind for the Glory of God
Website:www.iubamenda.org
APPLICATION FOR ADMISSION (BSc)
Please complete the form and return with appropriate application and processing fees with four passport .
Size Photographs, and copies of certificates.
1. Name:
2. Nationality:
3. Current Address:
4. Permanent:
5. Sex:
6. Occupation:
7. Date of Birth:
8. Religion:
9. E-mail:
10. Telephone:
11. List Schools Attended
Schools Attended Location From To Qualification Obtained
12. List 3 areas of specialization in order of preference you would like to pursue
1.
2
3.
13. Work Experience
Nature of Work From To Employer and Address
1
14. a. WEST AFRICAN SCHOOL CERTIFICATE b. G.C.E ORDINARY LEVEL
Subject Grade Subject Grade Date
Months and Month and
years taken years taken
Centre Centre
Exam No. Exam No.
15. National Diploma (ND) /NCE
Courses Grade Courses Grade
Date Date
A.G.P.A Centre
OVERALL GRADE EXAM
2
16 List your special talent:
17. What are your hobbies?
18. Cite extra curricular, community, and personal activities in which you have been a significant
participant such as performing Arts, Church Group, Development Matters, Community Service, Student,
Government, Games, or Publication. Mention your position:
19. Cite honours, recognition or awards you have received for scholastic, athletic, community service,
humanitarian service or other outstanding achievements. Include inter house or inter school competitions.
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20. How is your healthy generally? ( ) Excellent ( ) Good ( ) Fair ( ) Poor
How is your sight? ( ) Excellent ( ) Good ( ) Fair ( ) Poor
How is your hearing? ( ) Excellent ( ) Good ( ) Fair ( ) Poor
21. What is your usual ailment?
22. Do you have any handicap? ( ) No , if “Yes” explain
23. State certificates and transcripts which copies you are submitting in support of this application
I understand that falsification of any information on this application could result in a rejection or dismissal.
Your signature Date
For office use only: