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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 
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PART B: Applicant’s Details 
Before you begin application, please take note: 
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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” 
City/Town:
     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: [  ]
v.

Email Address:
PART C: Last School Attended 
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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

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PART D: Program Applying For 
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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): 
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PART F: Refund Policy:
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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?
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 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: 
FOR OFFICE USE ONLY RESERVED COLUMN
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By sending this application to the IICSE University officials, you certify that, to the best
Date: 
of your belief, the information you have provided above is complete and true. 

Applicant’s Signature
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All Rights Reserved. mi513-A .

Return the completed Application Form ‘email attachment’ to: study@iicseuniversity.org

Direct Admission Form: 2 of 2