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  ONLINE APPLICATION FORM  
       
 

Personal information

 
       
  Name of student:  
  Date of birth: /  /            
  Place of birth:  
  Nationality:  
  Passport number:  
  ID number:  
  Gender: Male      Female  
       
 

Contact details

 
       
  Current address:  
  City:  
  Country:  
  Phone number:     
  GSM number:     
  E-mail address (1):  
  E-mail address (2):  
       
 

Secondary school information

 
       
  Name of secondary school:  
  Year of graduation:     
       
 

Details of your sponsor

 
       
    Private     Government      Company  
  Name of sponsor:  
  Current address:  
  PO Box Number:  
  Postal Code:  
  City:  
  Country:  
  Phone number:     
  GSM number:     
       
 

Degree programme to join after Foundation Year

 
       
     After the Foundation Year I would like to enroll for the following programme:  
    Deck Officer  
    Marine Engineering Officer  
    Port, Shipping and Transport Management  
    Operation Technology (Oil and Gas and Petrochemicals Industry)  
       
       
 

The form will be send to the Admission and Registration Department.

 
       
       

PO Box 2954  PC 111 - CPO - Seeb Muscat Sultanate of Oman
Telephone: +968 24 52 14 66 or 14 99, Fax: +968 24 52 14 46, E-mail: info@imcoman.net
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