2023 Admissions Online Application Form | KIHSR | Kafue Institute of Health Sciences & Research

First Name

Last Name

Other Names

Marital Status *

Gender *

Male

Female

Date of Birth *

Place of Birth *

Nationality

Province

Central Province Districts

Copperbelt Province Districts

Eastern Province Districts

Luapula Province Districts

Lusaka Province Districts

Muchinga Province Districts

Northern Province Districts

Northwestern Province Districts

Southern Province Districts

Western Province Districts

NRC or Passport

Applicants Email Address

Important: Ensure this is a valid applicants email address.

Applicants Phone

Important: Ensure this is a valid applicants phone number.

Residential Address

Postal Address

District of Residence *

Contact info