FINS MEDICAL UNIVERSITY STUDENT APPLICATION FORM *TitleMr Miss Mrs. *First Name:*Last Name:*Sex:Male Female *Date Of Birth*Country Of OriginUganda Kenya Tanzania Rwanda Sudan Democratic Republic of Congo Afghanistan Albania Algeria Andorra Angola Antigua and Barbuda Argentina Armenia Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Bulgaria Burkina Faso Burundi Côte d'Ivoire Cabo Verde Cambodia Cameroon Canada Central African Republic Chad Chile China Colombia Comoros Congo (Congo-Brazzaville) Costa Rica Croatia Cuba Cyprus Czechia (Czech Republic) Democratic Republic of the Congo Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Eswatini (fmr. *District:*Town*Residential AddressContactEmail Adress*Do you have any physical disability Yes No *Desired ProgrammeCertificate Diploma Bachelors Postgraduate *Select CourseBachelor of Medicine and Bachelor Surgery Bachelor of Pharmacy Bachelor of Medical Laboratory Technology Direct Bachelor of Medical Laboratory Technology Completion Bachelor of Science in Medical Education Bachelor of Nursing Science Bachelor of Midwifery Science Bachelor of Science in Public Health Bachelor of Environmental Science Diploma in Medical Laboratory Technology Diploma in Clinical Medicine Diploma in Pharmacy Diploma in Nursing Extension Diploma in Midwifery Extension Certificate in Nursing Certificate in Midwifery Certificate in Pharmacy Higher Certificate in Biological Sciences (Bridge) 1. School / Institution / University AttendedQualification Attained:UCE UACE CERTIFICATE DIPLOMA DEGREE Upload Academic Document (6MB)2. School / Institution / University Attended:Qualification Attained:UACE CERTIFICATE DIPLOMA DEGREE Upload Academic Document (6MB)3. School / Institution / University Attended:Qualification Attained:CERTIFICATE DIPLOMA DEGREE Upload Academic Document (6MB)Practicing License (If you are applying for Diploma)Name of Sponsor:Telephone:Email Address:Address:CountryUganda Kenya Tanzania Rwanda Sudan Democratic Republic of Congo Afghanistan Albania Algeria Andorra Angola Antigua and Barbuda Argentina Armenia Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Bulgaria Burkina Faso Burundi Côte d'Ivoire Cabo Verde Cambodia Cameroon Canada Central African Republic Chad Chile China Colombia Comoros Congo (Congo-Brazzaville) Costa Rica Croatia Cuba Cyprus Czechia (Czech Republic) Democratic Republic of the Congo Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Eswatini (fmr. *Agreement I certify that the information I have submitted on the application form and the documents I have submitted to be true and accurate. I understand and agree that any false or misleading information will justify a denial of admission into the university. FINS MEDICAL UNIVERSITY BANK DETAILSBANK: ABSA BRANCH: FORT PORTAL ACCOUNT NAME: FINS MEDICAL UNIVERSITY LTD ACCOUNT NUMBER FOR DOLLAR: 6008548267 ACCOUNT NUMBER FOR UGX: 6008548275 SWIFT CODE: BARCUGKX Fields with (*) are compulsory. Application Progress