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IJMB Online Application

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Application Instructions

  1. The form below is ONLY for those applying for IJMB Programme
  2. Before filling the form, CLICK HERE to read about Ritman University IJMB Programme
  3. Carefully complete the form. Ensure you fill the mandatory fields with asterisk (*).
  4. Upload your recent passport with red background, should not be more than 200kb and MUST be in any of JPEG (JPG) or PNG format.
  5. Ensure you check through before clicking the Submit Button.
  6. Feel free to contact us where you have difficulty.

PART A: Personal Details (IN BLOCK LETTERS)

Title:
Surname:*
Other Names:
Sex:*
NRIC/Passport No.:
JAMB Reg. No:*
Corresponding Address:
Permanent Address:
Bank Paid:
Upload recent Passport:*
First Name:*
Marital Status:*
Date of Birth:*
Expiry Date:*
Do you have any Disability?:*
If yes, specify:
Nationality:
E-mail:
Mobile Phone:*
-
Telephone:
Facsimile:
Parent/guardian /Sponsor Name:
Parent's Phone Number:
NRIC / Passport No.:
Bank Payment Teller Number:

PART B: Educational Qualifications (Compulsory for Admission)

SECONDARY SCHOOL ATTENDED

Name of School:
Number of Sittings:*
Subject 1
Subject 2
Subject 3
Subject 4
Subject 5
Subject 6
Subject 7
Subject 8
Subject 9
Subject 10
Subject 11
Year Attended:

.

Certificate Obtained:*
Exam Reg./Centre No: (e.g 4040620/084)*
Grade 1
Grade 2
Grade 3
Grade 4
Grade 5
Grade 6
Grade 7
Grade 8
Grade 9
Grade 10
Grade 11
Year Attended.:

PART C: Applicant Declaration

I Agree:*

I declare that the information provided by me in connection with the application is true and correct. I undertake to inform Ritman University immediately of any changes in address, phone numbers and any other information by me in this application. I understand that Ritman University reserves the right to vary or reverse any decision regarding admission or enrollment made on the basis of incorrect or incomplete information.