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Applicant Information
*Last Name: *First Name: *Middle Name:
*Phone Number: *Email Address:
*City of Residence: *Province of Residence:
*Date of birth: *Age: *Gender:
MaleFemale
*City of birth: *Province of birth:
*Employment: *Marital Status:
Employed Unemployed
Single Widowed MarriedDivorced
Guardian information:
First Name: Middle Name: Last Name
Relationship Phone number Email address
Education Plans:
*Enrollment Semester:
Fall Semester Spring Semester Summer Semester
*Enrollment Year *Degree Desired:
Bachelors Degree Diploma Associates Degree Certificate
*Area of Study: *Have you previously applied? If yes, when?
Yes No 
*Have you visited the Campus? *Have you graduated from high school? *What year did you graduate from high school?
Yes No
Yes No
*Have you met with a PSU Admissions Representative? *Who will be responsible for paying your college tuition? *How did you learn about PSU?
Yes No
Additional Information:
Do you chaw khat? (Optional) Do you smoke? (Optional) *Have you ever participated in army conflicts?
Yes No Yes No
Yes No
*Do you own a gun now?
Yes No
Agreement
By clicking "Submit", I hereby certify that the information given in this application is correct and compete to the best of my knowledge, and hereby give my permission to the Admissions Committee to obtain any verification deemed necessary to process my application. I further certify that I will arrange for the forwarding of the official transcripts as requested in the instructions and that such transcripts become the property of the university and will neither be forwarded to another institution nor returned to me. I will include with this application my application fee and other documents as required in the application instructions.

 

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