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PART A: Payment Details
. IICSE University
Date of Payment:

Application Form
Amount Paid:
Method of Payment: IICSE University
(e.g.For Undergraduate
PayPal, Card, Bank, etc) and Postgraduate Studies ...a liberal arts education.
Teller / Transaction ID: .

Application Form for Direct Admissions 

PART B: Applicant’s Details 
Before you begin application, please take note: 

Student’s Full Name:

1.  All necessary fields must be filled.  Incomplete application may be delayed. 
2.  A Processing Fee of $150 USD or €138
Mailing Address: EUR must be paid before completing this form.   You will receive a    
    “Transaction ID” into your email immediately after your payment is received. Forms without a “Transaction ID” 
     shall not be treated. Please enter your “Transaction ID” at the appropriate field (PART A) below.  
Country of Residence:
3.  You will receive your Admission Letter together with supporting document, immediately after your completed 
Residential Continent:
     application is received and processed. 
(e.g. USA, UK, Africa, Asia, etc.) All necessary fields must be filled correctly:
Date of Birth: Please tick [√] one: 
Nationality:     Male: [  ]      Female: [  ]

Email Address:
PART C: Last School Attended 

Name of School:
Address of School:
Highest Qualification:
Year of Admission:
Overall Final Grade: Year of Graduation: 
e.g. Cum Laude, Second Class 
Lower, Credit, Pass, etc.

Direct Admission Form: 1 of 2


PART D: Program Applying For 
PART E: Breakdown of Fees for All Programs, including Doctoral Research Degree programs:
Program Applying for: .

We charge a one-time Application Processing Fee of $150 and an Exam Processing Fee of $50 per exam to
e.g. Bachelor of Arts,  MBA, PhD
Course Applying for: cover the cost of processing the examination.
Application Processing Fee
e.g. Law, Accounting, Nursing, etc. = $150 payable before admission
Insert your passport­size
Normal Program Duration:Exam Processing Fee (per exam) = $50 per exam payable per exam
photograph here
Graduate Portfolio Fee
(e.g. 9 months, 3 years, etc) = $200 upon graduation payable after graduation
Specify your desired Upon graduation, a student is expected to pay Graduate Portfolio Fee of $200 as shown above. Graduate Portfolio
Duration of Study (optional): contains the University Degree, a Recommendation Letter and Transcripts showing Statement of Results.

Starting Date (Month/Year): 

PART F: Refund Policy:

Application Processing Fee is refundable if admission is denied. No refunds will be granted or

. given for cancellation or withdrawal from study.
PART G: Please Tell Us, How did you get to know about IICSE University?

 Please tick [√] one: Internet [  ],    Friends [  ],     Staff [  ],    Student [  ] Others specify: 

If Friend, Student or Staff is ticked then, write the names of the Friend, Student or Staff here: 

By sending this application to the IICSE University officials, you certify that, to the best
of your belief, the information you have provided above is complete and true. 

Applicant’s Signature

All Rights Reserved. mi513-A .

Return the completed Application Form ‘email attachment’ to:

Direct Admission Form: 2 of 2