Apply Form - IMIC Education

IMIC PVT.LTD.

Putalisadak-30, Dillibazar Kathmandu

1) Personal Information

Name ( Mr/Ms)

Gender:

Father Name:

Date of Birth:

Current Address

Permanent Address

Passport No.

Mobile No.

Marital Status:

Email:

PP Size Photo ( Max File 2 MB )

2) Acadernic Oualiflcatlon

Name of Institute

Level

Passed Year

Interested Country

Which Program:

Have you taken any test? - IELTS / TOEFL / PTE / NAT / JLPT / SAT

Have you been rejected any countries:

Yes No

3)Work Experience ( If Applicable)

4) Family sources of Income

Remarks