Polytechnics Mauritius Ltd
Application form for International Students
Applicant's Personal Particulars
First Name
*
Surname
*
Address
*
Date of Birth
*
Gender
*
Select
Male
Female
Nationality
*
Mobile Number
*
Phone Number
*
Email
*
Passport Number
*
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Details of Responsible Party
Name
*
Relationship
*
Contact Number
*
Residence/Work permit Number
*
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Course Applying For
Course Title
*
Select Course Title
National Diploma in Nursing - Full time application only
Bachelor of Nursing (Top Up)
Certificate in IT
Diploma in IT (Cybersecurity)
Diploma in Game Development
Diploma In Digital Marketing
Diploma in Interactive and Digital Media
Diploma in ET (Big Data Analytics)
Diploma in Information Systems(Business Computing)
Diploma in Robotics and Automation Engineering
Bsc(Hons) Emerging Technologies - Top up - Closed for Application
Diploma in Hotel Management Full time application only
Diploma in Leisure Management - Full time application only
Diploma in Logistics Management - Closed for enrolment
Diploma in Architectural Studies (UCSI (Malaysia))-Full time application only
Diploma in Interior Architecture (UCSI (Malaysia)) - Full time application only
Select the Course Type
*
Select
Full Time
Part Time
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Education History-Academic Qualification
Highest Academic Qualification
*
CPE
PREVOC
FORM3
NTC
FORM4
FORM5
SC/GCE 'O' Level
HSC/GCE 'A' Level
Diploma
Degree
Please tick your highest academic qualification
Other Degree
*
Any other degree, please specify here
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Details of Highest Academic Qualification
Institution
*
Subjects, Grade, Year
*
Ex. Math - A - 2020
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Other Related Academic/Technical Qualification
Qualification
*
Institution
*
Year
*
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Work Experience
Employer Name
*
Position
*
End Date
*
Reason for Leaving
*
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Declaration of Criminal Record
Have you ever been convicted of any offence?
*
Select
Yes
No
If the answer above is YES, p
lease disclose details of your offence and conviction, including dates and courts convicted at. You may submit this information along with your application form in a separate sealed envelope clearly mentioned confidential with your name on it.
If you are convicted of a criminal offence after your application has been submitted, you must notify us. Polytechnics Mauritius Ltd may request further disclosure from you.
*
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Medical Detail
At Polytechnics Mauritius Ltd, all offers are made on academics grounds only and the information you submit will be used to help us to provide you appropriate support. We encourages you to disclose any disability/medical condition which could disadvantage your ability to study.
Do you have any Health Issue?
*
Select
Yes
No
If the answer above is YES, please provide the details of your medical condition in the text box below.
*
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Personal Statement/ Additional Information
The objective of the personal statement is for Polytechnics Mauritius to learn about you. Your past experience (if any), strengths, weaknesses, hobbies, anything you are passionate about and future plans after completion of your desired programme.
*
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Declaration of Applicant
Name
*
I .........................the undersigned applicant hereby declare that the above information is true and accurate.
Name of the Responsible Party
*
(If applicant is under 18)
Contact Number of Responsible Party
*
Date
*
Note:
Please attach photocopies of your birth certificate(new format), national identity card, educational and technical qualifications and any other related documents. All information will be treated confidentially.
Birth Certificate
*
(New Format)
Passport Number
*
Educational Qualification
*
Add a Zip file of Educational Qualification
Technical Qualification
*
Add a Zip file of Technical Qualification
Medical Certificate
*
Please attach medical certificates e.g HIV, Hepatitis,
Other Documents
*
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How Do You Know About Polytechnic Mauritius
Where you have you learned about us?
*
Newspaper
Radio
TV
Polytechnics Website
Job Fair
Friends
Open Days
Talks
Facebook
Instagram
Others, please specify..
*
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