ICOM Application Form

INTERNATIONAL COLLEGE OF MAKENI (ICOM)

32 Makama Road, Makeni

info@icom.edu.sl

www.icom.edu.sl.com

(+232) 76 754271
Application Form

Please fill out the application form carefully
Personal Information
Full Name*

First NameMiddle NameLast Name
Birth Date*

MonthDayYear
Gender*
Course*
Communication Information
E-mail*
example@example.com
Phone Number*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Guidance Personal Details
Full Name*

First NameLast Name
Relation*
Occupation*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
example@example.com
Phone Number*
Please enter a valid phone number.
Previous Educational Background

List your previous schools, beginning with the most recent
College/University
University Name
Study Field
University Location

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date Graduated

MonthDayYear
Date
GPA
Secondary
School Name
Study Field
School Address
Date Graduated

MonthDayYear
Date
Refree Personal Details
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Working Experience
Employee Name
Job Title
Address

Street Address

CityState / Province

Country
Student's Attachments
Birth Certificate*

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WASSCE Result

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Transcript

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Upload Passport Photo*

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Applicant Declaration
I your name* hereby declare that the particulars in this form are, to the best of my knowledge correct and that it is a criminal offense to submit false grades.
Date of Submission Date*.
Application Form Payment details

Payment should be done at the following bank account below.
AAPPLICATION FORM FEE: Nle 500
BANK: Sierra Leone Commercial Bank
ACCOUNT NAME: International College of Makeni
ACCOUNT NUMBER: 003 006 124 382 112 008
Prove of Form Fee Payment*

Please upload receipt of payment
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Should be Empty:

Application Form

Personal Information

Communication Information

Guidance Personal Details

Previous Educational Background

College/University

Secondary

Refree Personal Details

Working Experience

Student's Attachments

Applicant Declaration

Application Form Payment details

AAPPLICATION FORM FEE: Nle 500

BANK: Sierra Leone Commercial Bank

ACCOUNT NAME: International College of Makeni

ACCOUNT NUMBER: 003 006 124 382 112 008