KESSBEN COLLEGE

APPLICATION FORM FOR ADMISSION TO FIRST DEGREE PROGRAMME TO BE

COMPLETED AND RETURNED TO:

THE REGISTRAR
KESSBEN COLLEGE, KUNTANASE –
P. O. BOX 16710, ADUM-KUMASI
Email: [email protected] or [email protected]

INSTRUCTIONS ON HOW TO FILL THE APPLICATION FORM

i. Cost of Application Form

Application fee of GH¢50.00 Applicants outside Ghana and Non-Ghanaians are required to pay
US $50.00 or its equivalent in International Money Order.

ii. Result slips/Certificates/Transcripts

Certified photocopies of result slips and/or certificates/transcripts should be attached to this form.
Original result slips or certificates must be presented for verification at registration.

ii. Photographs

Two recent passport–size photographs should be attached to this form. (One of the photographs
should be endorsed). Names should be written on back of the other photograph).

iii. Corroborative Declaration:

This portion of the form should be signed by someone of high repute, and who knows the
Applicant personally. He/she should endorse one of the Applicant’s photographs.

For further inquiries, please call: +233 (0) 322 – 397850 / 397851 / 397852/0501 63 73 83

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 KESSBEN COLLEGE
APPLICATION FORM FOR ADMISSION TO FIRST DEGREE PROGRAMME TO BE COMPLETED AND
RETURNED TO THE REGISTRAR, KESSBEN COLLEGE, KUNTANASE - P. O. BOX 16710, ADUM-KUMASI
Affix Passport
Photograph here

470 x 470 pixels

A. PERSONAL DETAILS:

(Mr./Mrs./Miss/Other……………………) Please circle appropriate title.

1. Surname: ……………………………………………………………………………………………………………………………………………………….

2. First name: ……………………………………………………………………………………………………………………………………………..

3. Other name(s): ……………………………………………………………………………………………………………………………………………….

4a. Date of Birth:……………………………………………………………………. 4b. Sex: Male Female

Day Month Year

5a. Nationality: ……………………………………………………………….. 5b. Place of Birth:……………………………………….........

6a. Hometown:……………………………………………………………….. 6b. Region/State……………………………………………….

B. ADDRESS

7. Postal Address:……………………………………………………………………………………………………………………………………………..

8. Residential Address:………………….……………………………………………………………………………………………………………………...

9a. Mobile Phone Number(s):…………………………………………………………………. E-mail...................................................

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10a. EDUCATION

Senior High School(s)/Senior Secondary School(s) Attended with dates:

Name of School & Location From To

10b. Mode of Application (tick)

SSSCE WASSCE GBCE Mature Other (Specify)………………………………………………….

11a. EXAMINATION DETAILS

Particulars 1st Sitting 2nd Sitting 3rd Sitting 4th Sitting

Month & Year

Exam Index No.

Examination Centre

Type of Exam/Board

11b. GRADE DETAILS:

Title of Subjects Examination Results (Grades) for both Core and Elective Subjects
st
1 Sitting 2nd Sitting 3rd Sitting 4th Sitting
CORE:
English
Mathematics
Integrated Science
Social Studies
ELECTIVES

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NB: Include photocopies of certificates, result slips and other relevant documents

C. PARTICULARS OF PARENT(S)/GUARDIAN(S)/CARETAKER(S)

1. Name:........................................................................................................................................................... .

2. Postal Address:.............................................................................................................................................

3. Occupation:......................................................................................................................................…………..

4. Tel. No.:..................................................................... E-mail:……………….........................................................

5. Relationship to the Applicant:………….......................................................................................................... …

D. CHOICE OF PROGRAMME OF STUDY:

Please refer to the codes listed below and indicate preferences for the Degree Programme(s) for which you
wish to be admitted.

01 B.Sc. Business Administration

a. (Accounting option)
b. (Banking and Finance option)
c. (Marketing option)
d. (Human Resource Management option)
02 B.Sc. (Mathematics)
03 B. Sc. (Information and Communication Technology
04 B.A. (English)

Indicate programme preferences by placing the appropriate code(s) in the boxes provided below:

1st Choice 2nd Choice 3rd Choice

E. PAST AND PRESENT EMPLOYMENT RECORDS (If applicable)

Institution Position Date(s)

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F. FINANCING OF UNIVERSITY STUDY (Please tick as appropriate):

1. Student Loan Trust 2. Study Leave 3. Self Financing 4. Other (Specify)……………………………

G. PREVIOUS ATTENDANCE AT A TERTIARY INSTITUTION:

i. Have you ever enrolled in a tertiary institution? YES [ ] NO [ ] if YES answer the following:

ii. Name of the Institution.............................................................................................................................

iii. Your name on your registration form............................................................................................ ………..

iv. Year of Admission....................................... (v) Hall of Residence (if applicable)...................................

v. Course/Programme of study.......................................................................................................... ………..

vi. Last year of study...................................................................................................................................

vii. Reason(s) for leaving the Institution............................................................................................. ………

…………………………………………………………………………………………………………………………………………………………….

H. DECLARATION BY APPLICANT:

I hereby declare that the information provided by me is true and correct, and that I should be denied admission,
and/or withdrawn from Kessben College if the information is found to be false.

1. Signature of Applicant ...................................................................Date ..................................................................

2. Name and Address of Corroborator ......................................................................................................................

........................................................................... Contact No.:......................................................................................

3. Signature of Corroborator …………………………………………………………………………. Date…………………………………………......

Note: All copies of documents submitted in connection with this application become the property of this Kessben College.

How did you hear of us?(Tick): TV Radio Student/Staff of KC Newspaper MOGPA Other (Specify…………………

For Official Use Only

Application Fee:………………………………………………………. Receipt No.:………………………………………………………………..

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Date:………………………………………………………………………. Signature:……………………………………………………………………

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