Mountains of the Moon University
Education Resource Management System
Application for Registration

General Choice of Programme Educational Qualification Reference Photo


Name*
Application Reference Number
Email ID*
Date of Birth*
Gender*
Nationality*
Phone*
National ID/Any Personal ID*
Attach National ID/Any Personal ID*
Passport Number/Any Personal ID*
Attach Passport/Any Personal ID*
Visa Start Date
End Date
Attach Visa Copy
Religion
Marital Status
District
Subcounty/Muncipality
Parish/Ward
Village/Cell
Next of Kin
District (Kin)
Sub County/ Muncipality (Kin)
Telephone (Kin)
Email (Kin)