eivorgba

AFFILIATION APPLICATION FORM
(For Institutions Seeking Academic or Theological Partnership with RKUC)

SECTION A: INSTITUTION INFORMATION

1. Institution Name:
2. Country of Location:
3. Year Established:
4. Accreditation/Registration Authority:
5. Accreditation/Registration Number:
6. Institution Type:☐ University ☐ College ☐ Seminary ☐ Institute ☐ Other: ___________
7. Institution Website:
8. Official Email Address:
9. Official Telephone Number(s):
10. Physical Address:
11. Mailing Address (if different):

SECTION B: CONTACT PERSON

1. Full Name:
2. Official Title/Position:
3. Email Address:
4. Telephone/WhatsApp Number:
5. Signature:
6. Date:

SECTION C: AFFILIATION DETAILS

1. Type of Affiliation Requested:☐ Academic Partnership ☐ Theological Affiliation ☐ Research Collaboration ☐ Dual Certification ☐ Program Validation ☐ Institutional Membership
2. Area(s) of Interest:☐ Arts ☐ Business ☐ Education ☐ Theology ☐ Law ☐ Information Technology ☐ Health Sciences ☐ Others: ____________
3. Expected Collaboration Objectives:(Describe your institution’s goals for affiliation with RKUC)
4. Proposed Programs for Partnership (if any):
5. Previous or Current Affiliations with Other Institutions:(List names and countries of affiliation)

SECTION D: REQUIRED DOCUMENTS

Please attach the following documents with your application:

  1. Institutional Accreditation/Registration Certificate (copy)
  2. Institutional Profile or Prospectus
  3. Academic Charter / Constitution (if available)
  4. List of Key Administrative Officers
  5. Evidence of Legal Status or Government Approval
  6. Curriculum or Program Outline (for specific collaborations)
  7. Any existing Memorandum of Understanding (MOU) or Intent Letter

SECTION E: DECLARATION

I, the undersigned, hereby certify that the information provided above is true and complete to the best of my knowledge. I acknowledge that the approval of affiliation with Rudolph Kwanue University College (RKUC) is subject to institutional verification, review, and the signing of an official Memorandum of Understanding (MOU).

Name of Authorized Representative: ___________________________________________
Position/Title: ___________________________________________
Signature: _____________________________ Date: ___________________

SECTION F: FOR OFFICIAL USE ONLY (RKUC OFFICE OF INTERNATIONAL AFFAIRS)

Date Received:
Reviewed By:
Position:
Remarks:
Recommendation:☐ Approved ☐ Pending ☐ Declined
Signature:
Date:

SECTION G: APPROVAL & ENDORSEMENT

Director, Office of International Affairs & Institutional Relations
Signature: ___________________________ Date: ___________________________

Vice President for Academic Affairs
Signature: ___________________________ Date: ___________________________

President / Chancellor
Signature: ___________________________ Date: ___________________________Submit completed form and attachments to:
Office of International Affairs & Institutional Relations
Rudolph Kwanue University College (RKUC)
Pipeline, Wein Town, Monrovia – Republic of Liberia
info@rkuclr.org |  rkuinfo77@gmail.com