Application Form

COURSE
Course

PERSONAL DETAILS

Full Name

Passport No/IC No

Date of birth

Gender

Male

Female

Phone

Mobile Number

Address
City
State
Country
Pin code

EDUCATION DETAILS
Name of the Degree	College/ School	Board / University	Year of Study From \| To	Major Subject	%	Division

PROFESSIONAL COURSES
Name of the Course	College/ School	Board / University	Year of Study From \| To	Major Subject	%	Division

CONFIDENTIALITY OF STUDENT DATA

Image School of Technology is committed to maintaining the confidentiality of the Students’ personal information and undertakes not to divulge any of the Student’s personal information to any third party without the prior written consent of the Student. Student’s particulars are solely for the purposes of completing course submission. When IMAGE wishes to use students’ particulars for purposes other than internal marketing and billing, it makes this known to the student before obtaining their particulars and obtains the consent of the student