GED Admission Form - American University of Cote d’Ivoire

Admission Criteria: Only students who have completed a 1ere or Terminale class can complete and SUBMIT this application FRENCH: Critères d'admission: Seuls les candidats en classe de 1ere ou Terminale qui n'ont pas le BAC peuvent remplir et soumettre cette demande d'admission dans le programme du BAC Américain.

GED Program Entrance Date Desired:

October
January
March
June

Personal Information

Name

First Last

Gender

Male
Female

Date of Birth / Date de Naissance

National I.D. #

Previous Last Name (If Applicable)

Place of Birth / Lieu de Naissance

(City/Village & Country)

Domicile

(City & District)

Email*

Cell Phone*

Home Phone (if any)

Is English Your First Language?

Primary Language

Emergency Contact

Emergency Contact Name

Emergency Contact Phone Number

Emergency Contact Relationship

Academic Credentials

Have you studied English in the past?

How many years?

What areas of the English language are you good at?

Speaking
Reading
Writing
Grammer

(Check all that apply)

Which of the subject areas below are you good at?

History & Geography
Mathematics
Science
Physics
Chemistry

(Check all that apply)

What is your objective after the GED program?

What is your career goal? / Quelle carrière aimeriez-vous?

Submit Application / Somettez Votre Demande

I certify that the information on this application is true and accurate. I understand that any misrepresentation, omission, or incorrect information shall be cause for disciplinary action up to dismissal, with no right of appeal or to a tuition refund.

Signature

Print full name / Imprimez Votre Nom.

Parent Signature

If under 18 / Si vous avez moins de 18 ans.

Date

Application Form / Demande D'Admission: GED Program

Personal Information

Emergency Contact

Academic Credentials

Submit Application / Somettez Votre Demande