Student Application | Leonards Homes

1

Personal Details

Provide your official identification and contact information.

Title

First Name *

Middle Name

Surname *

Date of Birth *

Ghana Card Number *

Phone Number *

Email Address *

Region *

Street Name *

House Number / Digital Address

Next of Kin Details

Title

First Name *

Surname *

Relationship *

Telephone Number *

Email Address *

2

Academic Details

Information about your current enrollment and studies.

Institution Name *

Course of Study *

Academic Level *

3

Health & Security

Important medical and background information for your safety.

Medical Information

Confidential Record

Your medical information is strictly confidential and will only be used for your safety.

Do you have any medical information to disclose? *

No, nothing to disclose Yes, I have disclosures

Do you have any medical conditions?

No Yes

Do you have any allergies?

No Yes

Are you currently on any medication?

No Yes

Criminal Record Information

Confidential Record

Disclosure of a previous record does not necessarily disqualify your application.

Do you have any criminal record information to disclose? *

No, nothing to disclose Yes, I have disclosures

Have you been arrested in the last 3 years?

No Yes

Do you have any pending police charges?

No Yes

Do you have any pending court charges?

No Yes

4

Accommodation

Select your preferred hostel and room configuration.

Preferred Region *

Preferred Hostel *

Type of Accommodation *

1 Bed Occupant 2 in a room 3 in a room 4 in a room

Preferred Visit/Selection Date & Time *

Intended Move-in Date & Time *

Do you have any specific accommodations or notes? *

5

Required Documents

Please provide clear scans or photos for verification.

Passport Photo *

Ghana Card (ID) *

Admission Letter *