KOFORIDUA TECHNICAL UNIVERSITY

P.O.Box KF 981, Koforidua, E/R

Ghana, West African

ACCEPTANCE OF OFFER OF ADMISSION FOR

THE 2021/2022 ACADEMIC YEAR.

SECTION I

• I, RICHMOND KOOMSON do hereby accept the Offer of Admission made to me and promise to comply with
the conditions that go with the offer and to abide unquestionably by all regulations governing students in the
Department in particular and the University in general and that should I default, I will submit myself to appropriate
disciplinary action in accordance with the Statutes and other Regulations of the Koforidua Technical University.

• Programme: Higher National Diploma In Computer Network Mgt..

Session: Morning.
School/Department: Department of Computer Science

• Addresss: P.O.BOX 72, BAWJIASE AWUTU, BAWJIASE AWUTU, GHANA.

Telephone/Mobile Number: +233596513227.
Email Address: rkoomson777@gmail.com

• Signed: ................................... Date: .........................

SECTION II

TO BE COMPLETED BY PARENT/GUARDIAN/SPONSOR

I fully endorse my ward’s acceptance of the Offer of Admission made to him/her. I sincerely vouch for his/her good
conduct and believe that he/she is fit and proper to be trained in the University.

I unreservedly declare support for the authorities in the maintenance of discipline in the training of my ward and further
undertake to see to his/her full maintenance and settlement of fees to enable him/her to complete the course. If he/she
falls foul of any provision of the University’s Statutes, Students’ Handbook or other Regulations of the University the
appropriate sanctions should be applied.

Relationship with Applicant (Parent / Guardian / Sponsor / Others) underlined

Name: .......................................................................

Occupation: ...................................................................

Address: .....................................................................

Tel/Mobile No.: ................................................................

Signature or Thumb Print of Parent/Guardian/Sponsor: ..................... Date: ............

SECTION III

Please make an additional copy of this Admission Acceptance Form and before submitting to the Admissions
Department on or before registration. Also, you are required to submit COPIES OF RESULTS SLIPS OR
CERTIFICATES during registration.

SECTION IV

Note: You are expected to read very well the Conditions for Admission before completing this form
 OTHER DATA ON STUDENT

1. PARENTAGE

a. Name of Father: ..................................... Is he alive? .............

b. Occupation of Father (if alive): ................................................

c. Place of Work: ...........................................................

d. Name of Mother: ................................. Is he alive? ...............

e. Occupation of Mother (if alive): ...............................................

f. Place of Work: ...........................................................

g. Are both parents still together (if they are both alive): ................................

2. WORKING EXPERIENCE

a. Have you ever worked? ......................................................

b. If Yes, state the Name and the Address of the last Organization(s) where you worked:

.........................................................................

.........................................................................

.........................................................................

Tel. / Mobile No.: ............................................................

3. EXTRA-CURRICULAR ACTIVITIES

What hobbies are you interested in: ................................................

(Attach copies of any certificates or testimonial of merit you may have obtained in your hobbies and in any
leadership endeavours)

4. Signature: ................................... Date: ...........................

SECTION V

FOR OFFICE USE ONLY

Signature: ....................................................

Date: ......................................................

Note: You are expected to read very well the Conditions for Admission before completing this form