Misrak Polytechnic College

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Trainee profile*

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First Name*

Middle Name*

Last Name*

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DOB*

Nationality*

Mobile Number*

Date of commencement*

PHYSHICAL DISABILITY (IF)*

Yes No

Special needs:(To add additionally that are not listed, type manually and press ENTER)

Place of birth

Country*

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City/region*

Sub city/zone*

Woreda*

Current Address*

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Sub-city/Zone*

Woreda*

House number*

Person to be contact in case of emergency

Parent/guardian

First name*

Middle name*

Last name*

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Relation*

Parent email

Parent mobile number*

Parent/guardian address

Click if same as trainee address

City/region*

Sub-city/zone*

Woreda*

House number*

Mother first name*

Mother middle name*

Mother last name*

Educational background

If transferred

Yes

Previous college*

Old Trainee id

Letter from previous college*

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Grade report*

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Educational information

Grade8 result*

Completion date*

Grade 10 Completed?*

Yes

Previously completed Education Information

Previous Education/Training Completion*

Previous institution attended*

Study Period From Year*

Study Period To Year*

Department*

Program*

Level of education*

Specify degree type*

Relevant supporting documents or certificates*

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Field or Study (In order of your choice)*

Attachments

Attach grade 8 result*

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Attach high school transcript*

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Attach ESLCE result

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Fees Information

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Statement by the applicant*

I hereby certfiy that all the information given above is complete and correct. I understand that in the event of deliberately given false information, I may be liable to dismissal from the center. If for whatever reason I am suspended, dismissed or withdraw from college, I cannot claim reimbursement if any fee paid. I undertake to abide by the rule and regilation of the college, including those of my department. I also herby deliberately observe the rules and regulation specially the fulfillment of tution fee in due date in conformity with the regulation of the centervand any other negligent act for which Iam leaglly bound.

Date*

Welcome

Registration for Previously Certified Applicants

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Place of birth

Person to be contact in case of emergency

Parent/guardian

Parent/guardian address

Educational background

Educational information

Previously completed Education Information

Field or Study (In order of your choice)*

Attachments

Fees Information

Statement by the applicant*

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