Student Registration

Registration Form

Complete your personal, education, guardian, and payment details.

First Name

Middle Name

Last Name

Gender

Date of Birth

Nationality

Region

District

Postal Address

E-mail

Phone *

Primary School *

Secondary School *

Form Four Index Number (S) *

Year Completed Form Four

Physics Grade

Chemistry Grade

Biology Grade

Full Name

Relationship

Mobile Number

Email Address

Postal Address

Application fee: Tshs 15,000/= should be paid through bank account number: 61010040170, Account name: Southern Highlands Society NMB.

Payment Reference

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