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2024 Enrolments forMbaHealthTechFintechAgritechnow open

Now

Register Online

Email

REQUEST INFORMATION

PLEASE SELECT PROGRAM

FULL NAME

DATE OF BIRTH

ALLOCATED STUDENT ID

CONTACT INFORMATION

EMAIL

PHONE NUMBER

MAILING ADDRESS

CITY

STATE / PROVINCE

POSTAL / ZIP CODE

EMERGENCY CONTACT INFORMATION

FULL NAME

RELATIONSHIP TO STUDENT

PHONE NUMBER

PREVIOUS EDUCATION

INSTITUTION

DEGREE / DIPLOMA

YEAR OF GRADUATION

MAJOR / FIELD OF STUDY

PAYMENT OPTIONS

PLEASE SELECT PAYMENT OPTION

PAYMENT SCHEDULE

PLEASE INDICATE ANY SPECIAL ACCOMMODATIONS OR REQUIREMENTS NEEDED:

TERMS AND CONDITIONS

PAYMENT METHOD

Total Programme Fee

SIGNATURE (WRITE FULL NAME TO SIGN)

DATE

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