LYCEE DE KICUKIRO APADE

Student Registration Form

Please fill out all sections below to complete your application for Multimedia Production (MMP)

I. Candidate Identification

Full Name *

Sex *

Birth Date *

Student Photo

O-Level Certificate Serial *

II. Parents Information

Father Information

Father's Name *

Father Alive?

Father ID Number

Father Phone

Mother Information

Mother's Name *

Mother Alive?

Mother ID Number

Mother Phone

Medical Insurance

III. Address of Parents or Responsible

Province *

District *

Sector *

Cell *

Village *

Responsible Person Name

Responsible Person Phone

IV. School Background

Previous School Name *

School Phone

Annual Marks *

Deliberation *

Previous School Province

Previous School District

Previous School Sector

Previous School Cell

Past School Report (PDF/Image)

V. Choice of Trades

Trade Level *

Trade Name *

Has Portfolio?

Attached School Report?

VI. School Fees Payment

Payer Type *

Payer Name *

Payer Phone *

Payer Email

VII. Special Educational Needs

Has Disability?

Disability Type

Has Medical Document?

VIII. Religion & Boarding

Religion

Boarding Required?

IX. Declaration

I declare that all information provided above is true and accurate. I understand that providing false information may result in the rejection of my application. I agree to pay the application fee of 10,000 RWF upon submission.

Multimedia Production (MMP)