University of Health and Allied Sciences

ONLINE APPLICATION FORM

2023/2024 ACADEMIC YEAR

Form Type : WASSCE/SSCE

Form Number : UHAS202322684

Personal Details

Surname AMANKWAH
First Name POKUA
Other Name(s) LAWRENCIA
Title MISS
Previous Name
Gender FEMALE
Date of Birth 2004-06-03
Religion CHRISTIANITY
Country of Birth GHANA
Phone 0552702170
Email AMANKWALAWRENCIA@GMAIL.COM
Nationality GHANA
Emergency
AGYEIWAA DORIS
Contact(Name)
Emergency
Contact 0249381549
(Address)
Emergency
0249381549
Contact(Phone)
Physically
NO
Disabled
Actual Disability
Marital Status SINGLE

Address & Guardian Details

 House No. E-BUN 0011
District ATWIMA KWANWOMA
Residential District KRACHI WEST
Hometown AHENEMA KOKOBEN
Residential Town KETE KRACHI
Region ASHANTI REGION
Residential Region VOLTA REGION

Programme and Grades

First Choice BACHELOR OF NURSING

Second Choice BACHELOR OF PUBLIC HEALTH (NUTRITION)
Third Choice BACHELOR OF PUBLIC HEALTH (HEALTH INFORMATION)
Fourth Choice BACHELOR OF PUBLIC HEALTH (HEALTH PROMOTION)
Fee Paying NO

No. of
Index Number Exam Type Subject Grade Month Year
Attempt/Level
CHRISTIAN RELIGIOUS
1050104070 WASSCE B3 1ST MAY/JUNE 2022
STUDIES (CRS)
1050104070 WASSCE CORE MATHEMATICS A1 1ST MAY/JUNE 2022
1050104070 WASSCE ECONOMICS B3 1ST MAY/JUNE 2022
1050104070 WASSCE ENGLISH LANGUAGE B3 1ST MAY/JUNE 2022
1050104070 WASSCE GOVERNMENT D7 1ST MAY/JUNE 2022
1050104070 WASSCE HISTORY C5 1ST MAY/JUNE 2022
1050104070 WASSCE INTEGRATED SCIENCE B3 1ST MAY/JUNE 2022
1050104070 WASSCE SOCIAL STUDIES A1 1ST MAY/JUNE 2022

Declaration

To be completed by the Candidate

I DECLARE that all the information given and attachments to this form are true and correct in every detail. I
understand that any forgery renders me liable to prosecution.

Signature : ..................................................... Date : ...................................... Close