CATHOLIC UNIVERSITY COLLEGE OF GHANA,

FIAPRE-SUNYANI.
ADMISSION FORM
Applicants should indicate by ticking the preferred as specified here.
Undergraduate Programmes August Admissions January Admissions Sandwich
Degree Diploma Regular Weekend August Admissions
Regular Weekend
January Admissions

A. Biodata (Applicant details)

Applicant’s name must correspond to those used for all examinations taken
Title (Mr./Mrs./Ms.)
Surname:
Affix one personal
passport size
First name: photograph with your
name and signature at
Middle Name(s):
the back

Date of birth (dd/mm/yyyy) Gender: Male Female

Place of Birth: Region/State of Birth:

Hometown Region/State of Hometown:

Nationality: Licence(if any): National ID No(If any): TIN No (if any):

If you are not a Ghanaian by birth kindly state your Passport No:
residential/citizenship status by ticking one or more of the
following;
Citizen by Marriage Place of Residence:
Citizen by Naturalization

Refugee
Region/State of Residence:
ECOWAS Permit
Others, Specify;

Occupation of applicant:

Note: Applicants who are refugees are required to provide evidence in writing from the Ghana Refugees Board

Religion: Diocese: (If Catholic or Methodist or Anglican):

The Church you attend (Denomination) if Christian: Marital Status: Married Single

No. of Children:

Personal Tel. / Mobile Number(s):

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Address to which communication on this application should Tel No(s):
be sent:
Applicant’s E-mail Address:

Permanent Home Address (if different from above): Tel. No.

Name and Address of Father: Father’s Occupation:

Tel. No:

Email:

Name and Address of Mother: Mother’s Occupation:

Tel No:

Email:

Name and Address of Guardian (where applicable): Guardian’s Occupation:

Tel No:

Email:

Are you physically disabled or do you suffer any form of handicap?

Yes No
If Yes, specify

Are you currently employed? If Yes, indicate the nature/type of employment.

Yes No

Name, Address and Phone number of present employer: Employer’s E-mail address:

How do you intend to finance your education?

Self Employer Scholarship Others, specify

If your choice is others or scholarship, Kindly provide details:

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B. Examination History:
Secondary Schools and Colleges attended (indicate dates of attendance and qualifications)
From From
Schools/Colleges Qualification(s) obtained
(Month, Year) (Month, Year)

Details of results of examinations taken as applicable. (Indicate subjects and grades at all attempts)
W.A.S.S.C.E/S.S.S.C.E and Others
GRADES
SUBJECTS ST
1 2ND 3RD

Examinations details

LEVEL S.S.S.C.E./W.A.S.S.C.E. G.C.E. “O” LEVEL G.C.E. “A” LEVEL

Attempt First Second Third First Second Third First Second Third

Month

Year

Index No.

Qualification of Applicant:W.A.S.S.C.E S.S.S.C.E. G.C.E. OTHERS

Other professional and certificate qualifications obtained:
Name of Examination Body/Bodies Certificate(s) Obtained
A

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C. Choice of Programme (Refer to Admission Brochure)

Indicate the order of your choice of programme

First choice
Programme Faculty/Department

Second choice
Programme Faculty/Department

Third choice
Programme Faculty/Department

Are you applying as a Mature Candidate? Yes No

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D. Statement of 150-200 words

Make a short statement of (150-200 words) hand-written indicating your career goals; the reason for
wishing to obtain a University Degree or Diploma; and why you wish to study at the Catholic University
College of Ghana, Fiapre.

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E. Declaration
I declare that the information provided is genuine and reflects my true records. (An applicant who makes a
false declaration or withholds relevant information may be refused admission. If he or she has come
into the University already; he/she may be asked to withdraw)

……………………………………… …………………………………………...
Date Signature of Applicant

F. Endorsement
The declaration in E. above must be endorsed below by someone of high repute. This person should be
a Parish Priest, Senior Public Servant or a person belonging to the learned profession (e.g. Lawyer,
Medical Practitioner) or a Headmaster/Principal of the applicant’s last educational institution

……………………………………………… …………………………………………………….
Date Signature
…………………………………………………….
Name
…………………………………………………….
Status
…………………………………………………….
Address

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G. Very Important

How did you hear of Catholic University College of Ghana, Fiapre?

Friends Family The Church Website
Radio Television Newspapers Self
Others, specify:
Where did you buy the Admission Application Form?

H. Referral Details by Applicant

If somebody recommended the University/Programme to you, would you kindly give the referrer’s details.

Name of Referrer: …………………………………………………………….……………………………………

Catholic University College of Ghana (CUCG) ID of student (if the person is a CUCG student):
……………………………………………………………………………………….………………………….……

FOR OFFICIAL USE ONLY

Application Form No……………………………………... Programme offered:……………………………………….

Mode of Admission: .…………………………………….. Faculty/Dept.:…………………………………………….

Direct WASSCE Date of Admission:………………………………………..

Direct SSCE

Direct SSCE/WASSCE & Others

Other Certificates

Specify; …………………………………………………… Schedule

……………………………………………………………... i. Full-Time Study (Regular)

ii. Part-Time Study (Weekend)
Remarks:………………………………………………….

……………………………………………………………..

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