ST. MARY'S HEALTH SCIENCE TRAINING INSTITUTE–JUBA
APPLICATION FOR ADMISSION
PRE-ADMISSION FORM
PRE-ADMISSION
This form must be taken to the school main campus for the final admission process.
St. Mary's HSTIJ Main Campus, Juba, South Sudan
Application ID: —
Date: —
PRE-ADMISSION / PENDING
STUDENT DETAILS
Full Name: —
Email: —
Phone: —
Program: —
Date of Birth: —
Gender: —
Place of Birth: —
Nationality: —
Boma: —
State: —
County: —
Payam: —
Emergency Contact: —
Education Level: —
SUBMITTED DOCUMENTS
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Senior Four Certificate / Academic Transcript — Copy attached
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National ID / Passport — Copy attached
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Passport Photo — Copy attached
DECLARATION
I declare that the information provided in this application is accurate and complete. I understand that providing false information may result in the rejection or cancellation of my application.
St. Mary's Health Science Training Institute–Juba • Gumbo Main Campus, Juba, South Sudan
stmaryhstij@gmail.com • Official pre-admission application form