PART A: Application Processing Fee Code

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Transaction Code:
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PART B: Applicants Details
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Applicants Full Name:
Mailing Address:
City/Town:
Country of Residence:
Residential Continent:
(e.g. USA, UK, Africa, Asia, etc.)
Date of Birt: Please tick [] one:
Male: [ ] Female: [ ] Nationality:
Mo!ile/"one
(+ include country code):
#mail Address:
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PART C: Last School Attended
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Name of School:
Address of School:
Highest Qualification:
Year of Admission:
Overall Final Grade:
e.g. Cum Laude, Second Class
Lower, Credit, Pass, etc.
Year of Graduation:
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PART D: Program Applying For
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Insert your passport-size
photograph here
Program Applying for:
e.g. Bachelor of Arts, MBA, PhD
Course Applying for:
e.g. Law, Accounting, Nursing, etc.
Course Duration:
(e.g. 9 months, 3 years, etc)
Starting Date (Month/Year):
Please turn over

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All Rights Reserved. mi513-A .
Return the completed Application Form email attachment! to: admissions,iicseuni-ersity*org
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PART E: List names of IICSE students you know who have graduated or currently studying with
the IICSE University:
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IICSE Students Name1:
IICSE Students Name2:
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PART F: Breakdown of Fees for All Programs, excluding Doctoral programs:
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"e charge a one#time Application $rocessing Fee of %&'( and a su)sidi*ed +,am $rocessing Fee of %&'
per e,am to co-er the cost of processing the e,amination.
Application $rocessing Fee . %&'( payable before admission
+,am $rocessing Fee (per e,am) . %&' per e,am payable per exam
.raduate "ortfolio Fee / 0122 upon graduation payable after graduation
Upon graduation, a student is expected to pay Graduate Portfolio Fee of $200 as shown above Graduate Portfolio
contains the University !ertificate, "ecommendation #etter and $ranscripts showing statement of results .
PART G: Breakdown of Fees For Doctoral Degree Applicants only:
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Application $rocessing Fee: . %&'( payable before admission
/octoral Research 0hesis Fee: . %1,23( paya)le for research payable for doctoral research
.raduate "ortfolio Fee: / 0122 upon graduation payable after graduation
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PART H: Official Recognition of IICSE University:
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445S+ Uni-ersity is an educational arm of the 445S+ "6R7/"4/+, 775 incorporated in the State of
/ela8are, U.S. /ela8are 9o-ernment Registration File num)er ':3:(1'.
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PART I: Results Upgrade (optional):
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"e do ;60 issue out our certificate to students 8hose grade#score is )elo8 2(<, grade =/> in a course.
?ou 8ould )e re@uired to pay a sum of %'( per e,am paper you did not fail, )ut 8ish to re#8rite the e,am
paper for the purpose of upgrade. Results Upgrade is ;60 compulsory.
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PART J: Refund Policy:
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Sorry, no refunds. All fee payments are final.
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PART L: Please Tell Us, How did you get to know about IICSE University?
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Please tick [] one: Internet [ ], Friends [ ], Staff [ ], Student [ ] Others specify:
If Friend, Student or Staff is ticked then, write the names of the Friend, Student or Staff here:
By sending this application to the IICSE University officials, you certify that, to the best
of your belief, the information you have provided above is complete and true.
Date:

Applicants Signature