Application Form - Application Form

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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

Citizenship

Country of Residence

Preferred Program

Preferred mode

Preferred Intake

Academic Documents

Identification Document

REFERENCES

Who Will Sponsor Your Education at International University of East Africa?*

Parent Guardian

Sponsor Address

Sponsor Telephone

Sponsor Email

HOW DID YOU HEAR ABOUT THE UNIVERSITY? *

Source of IUEA Interest

University Website University Prospectus/flyers/Brochures Television Radio Newspaper Exhibition & Recruitment Fairs Church/Organization Relative/ & Friends Alumni Staff/Faculty Social Media Agent Visit to university campus SMS Email

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.