APPLICATION REF No ------------------------------ DEPARTMENT OF PROCESS OPERATIONS TECHNOLOGY APPLICATION FORM BACHELOR IN PROCESS OPERATIONS TECHNOLOGY (PART TIME) Instructions to the candidate. 1. Fill up all the details in application form with correct information. 2. Submit the photocopy of following certificates along with application form 1. Grade – 12 Certificate 2. Civil ID card 3. Diploma certificate 4. Academic Transcript (For Diploma) 5. Experience certificate 6. No objection certificate (From employer) Note: 1. 2. If any of the details are incorrect in the application form, Failure to get the admission in Part Time Studies. Do not enclose the any training certificates with this application form. POST BOX No: 532, P.C.CODE: 322, FALAJ AL QABAIL, SOHAR, SULTANATE OF OMAN, TEL: +968 26 82 77 77, +968 26 82 77 88 EMAIL: info@imco.edu.om FAX: +968 26 82 77 44 WEBSITE: www.imco.edu.om Page 1 of 4 NAME NATIONALITY ID NUMBER GENDER MALE FEMALE ADDRESS FOR COMMUNICATION TELEPHONE NUMBER (RESIDENCE) MOBILE NUMBER EMAIL ID CONTACT DETAILS ( In case of Emergency) NAME MOBILE NUMBER TELEPHONE NUMBER (RESIDENCE) RELATIONSHIP PLACE ACADAMIC DETAILS(GRADE -12) NAME OF SCHOOL AVERAGE GRADE SCORED IN GRADE - 12 ENGLISH MATHS CHEMISTRY PHYSICS ACADAMIC DETAILS( DIPLOMA) TITLE OF THE DIPLOMA AREA OF SPECIALISATION NAME OF THE COLLLEGE / UNVERSITY GPA POST BOX No: 532, P.C.CODE: 322, FALAJ AL QABAIL, SOHAR, SULTANATE OF OMAN, TEL: +968 26 82 77 77, +968 26 82 77 88 EMAIL: info@imco.edu.om FAX: +968 26 82 77 44 WEBSITE: www.imco.edu.om Page 2 of 4 EMPLOYMENT DETAILS NAME OF THE EMPLOYER POSITION & EXPERIENCE WORKING SCHEDULE DETAILS WEEKLY WORKING DAYS ON WEEKLY WORKING DAYS OFF DECLARATION The above information is true to the best of my knowledge and I will abide the Rules & Regulations of the college. Signature Date POST BOX No: 532, P.C.CODE: 322, FALAJ AL QABAIL, SOHAR, SULTANATE OF OMAN, TEL: +968 26 82 77 77, +968 26 82 77 88 EMAIL: info@imco.edu.om FAX: +968 26 82 77 44 WEBSITE: www.imco.edu.om Page 3 of 4 For Office Use Comments – Part Time Studies Coordinator / Admission Signature Date Comments – Part Time Coordinator / POT Department Signature Date Comments – HOD / POT Department Signature Date Comments – HoD Admission & Registration Signature Date POST BOX No: 532, P.C.CODE: 322, FALAJ AL QABAIL, SOHAR, SULTANATE OF OMAN, TEL: +968 26 82 77 77, +968 26 82 77 88 EMAIL: info@imco.edu.om FAX: +968 26 82 77 44 WEBSITE: www.imco.edu.om Page 4 of 4