Student Online Application Form

Applicant Details

First Name: Last Name
Initial(s) Title
Nationality Identity Number
Passport Number Date Of Birth

Postal Address

PO Box Number Suburb
City Country
Postal Code    

Physical Address

Street Address/Complex/Unit Suburb
City Province
Code Country

Applicant Contact Details

Telephone (Home) Fax
Telephone (Work) Email
Mobile Number    

Course Information

Student Type Course Type
Course Mode
Please indicate where you will be writing your examinations:
Please indicate whether your contact details may be given to other students:
Where did you hear about REGENT BUSINESS SCHOOL?

Academic Qualifications

Institution Qualification Completed Year Completed Duration of Qualification
Attach Certificates :
Attach ID/Passport :
Attach signed Application Form :


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