Application Form - IUEA Application Form

Title

First Name

Last Name

Date of Birth

Country of Birth

Gender

Male Female

Passport Photo (file formats allowed jpg or png)

Email Address

Telephone/Mobile No

ADDRESS DETAILS

Postal Address

City/Town

Country of Residence

Mode of Study

Preferred Intake

Preferred Program

Academic Documents

Identification Document

REFERENCES

Sponsor Address

Sponsor Telephone

Sponsor Email

HOW DID YOU HEAR ABOUT THE UNIVERSITY? *

Referred by Agent

Other Sources

DECLARATION

I confirm that the information I have given is true, complete and accurate. I am fully responsible for its validity.