Applications – O'mark School of Health Technology

Personal Biodata

Surname *

First Name *

Other Name *

Phone Number *

Date Of Birth *

Gender *

Conatct Address *

Email *

Educational Background

Exam Type *

Subjects *

Subjects

Exam Date *

Grade *

Grade

Exam No / Serial No *

O'Level Result

Drop your file here or click here to upload

upload your olevel result. if you are providing two sittings, scan it together and upload. Max upload should not be more than 70kb

Primary School *

Secondary School *

Foundation Program/ Other school

Year Attended with Dates *

Year Attended with Dates

Program of Interest *

Fathers Name *

Fathers Email

Fathers Phone Number

Mothers Name *

Mothers Email

Mothers Phone Number

Guardians Name(if applicable)

Guardians Email

Guardians Phone Number

Signature of Parent/Guardian

I/We hereby declare that the information provided is accurate and true. I/We understand that any false information may lead to the rejection of the applicant application. *

Father/Mother/ Guardian signature

Drop your file here or click here to upload

clear signature

Applicant Passport Photograph *

Drop your file here or click here to upload

Passport photograph should be in WHITE background and should not be more than 50kb.

Applicant Signature

Drop your file here or click here to upload

Your signature should be clear and should not be more than 50kb.

Declaration *

Comment