Highland College of Technology

....taking you technically higher

Highland Students' Application Form

N.B All required field are marked with [*]

Personal Data

* Lastname:		* Firstname:
Othername:		* Mobile No:	(Phone Number)
* Email:	(E-mail)
* Sex:
* Date Of Birth (dd/mm/yyyy):		* Mother Tongue:
* Marital Status:		Other Language:
* Nationality:
* State Of Origin:		* Contact Address:

* L.G.A:
* Level Of Education:
* Photograph:
	Insert your photograph above. It's dimension should not be less than width 150px X height 200px.

Course Information

* Course Title:		* Year Of Study:
* Mode Of Admission:

Qualification

Sponsor

Next of kin

Funding

* Funding:

Accomodation

* Accomodation:

Payment Deatails

* Bank Name:		* Branch Of Bank:
* Deposit Slip No:		* Payment Date (dd/mm /yyyy):