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Online Application Form
Non Degree Programs / Short Term Courses
Please Select the Course
Certificate Course (10 months)
Dental Assistant
Medical Assistant - Laboratory
Medical Assistant - Administration
Medical Assistant - Clinical
Physical Therapy Assistant
Nurse Assistant
Pharmacy Assistant
   
Certificate Course (Short Term)
Nursing Review for Licensing Examination
Pharmacy Preparatory Course for Licensing Examination
Educational Counseling
Introduction to Health Careers
Certificate In Medical Terminology
Medical Billing and Coding
Medical Insurance Billing
Dental office Management
Phlebotomy
Nutrition for Sports and Human Performance
Legal Fundamentals of Health Care and Public Health
   
 
Infection Control for Non-clinical Healthcare Workers
Clinical Nutrition
Geriatrics
ECG Monitor Technician
Pharmacy Review
Pharmaceutical Sales and Marketing
Basic Surgical Skills
ECG & Rhythm Interpretation
Basic Arabic for Health Professionals

COURSE AVAILABILITY
(please select your priority time) Weekend/Evening*
 
PERSONAL DATA
Name *: Name is required. (As recorded in your Passport)
Sex *: Please select Male/Female.
Date of Birth : Please select Date. / Please select Month. / Please select Year. Please select Year.
Age as on 31st December of Admission year *: Age is required.
Email *: Email is required.Invalid format.
Nationality* : Nationality is required.
Marital Status : Please select Marital Status.
Mother Tongue : Mother Tongue is required.

Language proficiency :
Read :
Write:
Speak:

Contact Details
Father / Guardian's Name : Father / Guardian's Name is required.
Address : Address is required.
Father / Guardian's Email : Email is required.Invalid format.
Telephone No.*: Telephone Number is required.
Telex / Fax :
Occupation of the Father / Guardian *: A value is required.
Annual income of Father / Guardian :
 
Address for Correspondence :
Telephone No. :
Telex / Fax :

Passport Details :
Passport Number *: Required: Passport Number.
Date of Issue Required:Passport Issue Date.
Date of Expiry: Required: Passport Expiry Date.
Issued at : Required: Passport Issued at.
Student Visa : Please select: Required/Not Required.
Hostel Accommodation : Please select: Required/Not Required.

ACADEMIC PARTICULARS
School Leaving Certificate
Name & address of the
School/College :
Name of the University / Board :
Reg. No. :
Number of attempts for passing :
Year of passing :

Examination Passed Higher Secondary / Equivalent exam ( 12 grade)
Name & address of the
School/College :		 Name & address of the
School/College is required.
Name of the University / Board : Name of the University / Board is required.
Reg. No. : Register Number is required.
Number of attempts for passing : A value is required.
Year of passing : Year of passing is required.

Any Higher Examination
Name of the Course/Degree :
Name & address of the
School/College :
Name of the University / Board :
Reg. No. :
Number of attempts for passing :
Year of passing :

English language proficiency
TOEFL / IELTS :
Score : TOEFL/IELTS Score is required.(Contact Office of Admission for Registry)
 
EMPLOYMENT
Employed: Yes No

PROFESSIONAL EXPERIENCE DETAILS:
Period of Employment/ Training Name of Hospital/ Institution Areas of Expertise/ Training
     
     

NOTE :INCOMPLETE APPLICATION FORM WILL NOT BE ACCEPTED
 
Certificate Course (10 months)
Dental Assistant
Medical Assistant - Laboratory
Medical Assistant - Administration
Medical Assistant - Clinical
Physical Therapy Assistant
Nurse Assistant
Pharmacy Assistant
Certificate Course (Short Term)
CERTIFICATE IN RESEARCH METHODOLOGY
Nursing Review for Licensing Examination
Pharmacy Preparatory Course for Licensing Examination
Educational Counseling
Introduction to Health Careers
Medical Terminology
Medical Billing and Coding
Medical Insurance Billing
Dental office Management
Phlebotomy
Nutrition for Sports and Human Performance
Legal Fundamentals of Health Care and Public Health
Infection Control for Non-clinical Healthcare Workers
Clinical Nutrition
Geriatric Healthcare
ECG Monitor Technician
Pharmacy Review
Pharmaceutical Sales and Marketing
Basic Surgical Skills
ECG & Rhythm Interpretation
Basic Arabic for Health Professionals
Colleges and Academic Programs



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