GIDEON ROBERT UNIVERSITY

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APPLICATION

FOR
ADMISSION
OUR VISION! OUR COUNTRY! OUR WORLD

SECTION A

APPLICANT’S PERSONAL PARTICULARS:
Mr. / Ms /Mrs. /DR (FIRST NAME)
SURNAME:
Date of Birth: / Nationality
Passport No for Foreign Students / Identity Reference:
Physical Address:
Postal Address:
Email: / Cell: / Fax:
Sponsor’s Particulars: Name
Residential/Physical Address
Signature of the Sponsor:
Tel/Cell No.: / Date of Application:
Signature of the Applicant: Date:

SECTION B: SELECTION OF THE PROGRAM OF STUDY

Tick below Details of the choosen program e.g. Dip. Law, LLB or MBA

(i)  Diploma Program (……………………………………………………………………)

(ii)  Degree Program (………………………………………………………………………)

(iii)  Master Program (………………………………………………………………………)

(iv)  PhD Program (……………………………………………………………………….)

Applicant’s Signature……………………………………………………………………………

ACADEMIC QUALIFICATIONS
Level Attained / Institution Attended / Exam Board / Grade/
Division / Year of Completion

SECTION C: SELECT THE SESSION BY TICKING

Morning Evening ODL

(Fulltime) (Parttime) (Open Distance Learning)

Applicant’s Signature:……………………………………………………………………

SECTION D:

ATTACH YOUR GRADE 12 CERTIFICATE

PROFESSIONAL QUALIFICATIONS
Qualifications Attained / Institution Attended / Grade(GPA) / Year of
Completion / Program
Duration

SECTION E:

ATTACH YOUR PROFESSIONAL QUALIFICATIONS

SECTION F:

WORK EXPERIENCE
Job Title / Organization / Duration
From…………..To………….
From……………To…………..
From ……………To…………

G REGISTRATION AND REFUND POLICY

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1.  I, further consent that my registration shall be approved upon payment of the Registration fees

and that the fee is NON- REFUNDABLE: Signature……………………………………

2.  That my boarding fee is NON – REFUNDABLE after 48 hours of Payment and that 70% shall

be refunded if claim made within 48 hours: Signature…………………………………………

3.  That my tutorial materials shall only be supplied to me 14 days after the payment of the semester fees in case of ODL students.

4.  That my 60% Tuition fees shall be REFUNDED to me by the University should I decide to

cancel my contract within 48 hours after Payments. Signature……………………………………

5.  That my 50% Tuition Fees shall be REFUNDED to me by the University Should I decide to

cancel my contract within 7 days after payments. Signature………………………………………

6.  That my 30% Tuition fees shall be REFUNDED to me by the University Should I decide to

cancel my contract within 14 days after payments. Signature …………………………………….

7.  No claim shall be honored after 14 days of payments. Signature……………………………… …

DECLARATION BY STUDENT
DECLARATION
I have read the Prospectus carefully and am fully aware of the details of the programs of the Gideon Robert University. I undertake to pay fees and all other dues to Gideon Robert University as regulated, and without delay and I undertake to abide by the rules and regulations of the Gideon Robert University.
Signature of Applicant ______Date ______
APPROVAL (for official use only)
Admission Fees: ______Registration: ______
Library: ______Others: ______
Approved by: ………………………………Sign………………………..Position……………………
Certified by:………………………………..Sign…………………………Position …………………….