Daystar Leadership Academy - Student Registration Form

Please read this instructions carefully

The process is a 2-stage process. You are required to fill this form only if you have paid to our bank account that was sent to you via SMS. If you're registering for Advanced Certificate Course, You will be required to fill additional details about your basic certificate course.

Please endeavour to fill out STEP ONE details, then click on the PROCEED TO STEP TWO button to move on to the next stage and fill that out also.

Advanced Certificate prospects must have passed a minimum of 13 courses in their Basic Certificate Course in Leadership.

Please Note:

Your passport photograph should not be more than 64KB in size and should be saved with your fullname e.g. adenekansokunbi.jpg

If you have any issue submitting this application form in Internet Explorer, please make use of Mozilla Firefox or any other browser. Thank you

STEP ONE

Course Selection

Please select a course of your choice

Basic Certificate Advanced Certificate

Set

Month

Year

Student Reg. No

Course DURATION

Payment Details

Please select your payment method

Cash Deposit Cheque Deposit

Teller No

Cheque No

Payment Date

Amount Paid

STEP TWO

Personal Information

Surname

Firstname

Other Names

Maiden Name

Title

Gender

Marital Status

Date of Birth

Residential Information

Address

City

State

Country

Nationality

Telephone(fixed)

Mobile

Workplace Data

Nature of Business

Position

Name of Business/Organisation

Office Address

State

Country

Office Number

Office Email

Spiritual Data

Please select your Religion

Christianity Muslim Others

Name of Church

Church Address

Area

Dept/Unit you belong

Pastor's Name

Please Specify

Upload a Passport size Photo