Ultimate Remedial School Admission Form - Assin Foso, Central Region

Full Name *

Email *

Amount (GHS) *

1 - GHS 200

Transaction Charge: , Total:

Surname (COMPULSORY) *

First name (COMPULSORY) *

Other Names

Sex (COMPULSORY) *

Male Female

Date of Birth (COMPULSORY) *

Place of Residence (COMPULSORY) *

Mobile Number of Sponsor (COMPULSORY) *

Postal Address (COMPULSORY) *

Last SHS Attended (COMPULSORY) *

Father's Name (COMPULSORY) *

Contact Number (COMPULSORY) *

Mother's Name (COMPULSORY) *

Contact Number (COMPULSORY) *

Course of Study (COMPULSORY) *

Core subjects

English Language Core Mathematics Integrated Science Social Studies

Elective Subjects (COMPULSORY) *

Upload Passport Picture (COMPULSORY) *

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Sponsor (If Any)

Name of Sponsor

Mobile Number

* are compulsory
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