MZUMBE UNIVERSITY (CHUO KIKUU MZUMBE) APPLICATION FORM FOR ADMISSION INTO DIPLOMA AND CERTIFICATE COURSES FOR THE ACADEMIC YEAR 2013/2014

Transcription

1 MZUMBE UNIVERSITY (CHUO KIKUU MZUMBE) APPLICATION FORM FOR ADMISSION INTO DIPLOMA AND CERTIFICATE COURSES FOR THE ACADEMIC YEAR 2013/2014

2 MZUMBE UNIVERSITY (CHUO KIKUU MZUMBE) P.O.BOX 1 Tel: +255 (0) /1/3/4 MZUMBE Fax: +255 (0) MOROGORO, TANZANIA Cell: +255 (0) Affix photo taken within the Last six months Carefully read the admission requirements before filling this form. Application without stated qualifications will not be processed. Non-refundable application fee of 30,000/= Tsh for East Africans and 30$ for non East Africans to be paid through CRDB Mzumbe University Account No. 01J This form must be filled and returned to the Admissions Office on or before 30 th June (USE BLOCK LETTERS) 1. APPLICANT S PERSONAL RECORD Surname (Mr./Mrs./Miss) Other Names: Postal Address: Tel: Birth and Nationality: Date: Nationality: Marital Status: 2. PROPOSED PROGRAMME/COURSE Academic Year: 3. ACADEMIC QUALIFICATIONS ATTAINED (i) Certificate of Secondary Education (C.S.E.E)/National Form IV/ or Equivalent. Name of School: From: To Centre: Year: Index Number: Specify Subjects Passed (Attach copy of certificate) 2

3 SUBJECT GRADE DIVISION (ii) Advanced Certificate of Secondary Education (A.C.S.E) /National Form VI or Equivalent Name of School: From: To Centre: Year: Index Number: Specify Subjects Passed (Attach copy of certificate) SUBJECT GRADE DIVISION 4. OTHER COURSES INSTITUTION COURSE OF STUDY YEAR OF STUDY AWARD 5. EMPLOYMENT RECORD JOB HELD NAME OF EMPLOYER FROM TO 6. DIPLOMA AND CERTIFICATE PROGRAMMES 3

4 Indicate your preferred programme of study by placing a tick on the left hand side. PROGRAMME 1 SCHOOL OF PUBLIC ADMINISTRATION AND MANAGEMENT Diploma in Human Resources (DHR)- Mbeya Campus Certificate in Human Resources Management (HRMC)- Mbeya Campus Certificate in Local Government Management (CLGM)-Main Campus 2 FACULTY OF LAW Diploma in Law (DL)- Mbeya Campus Certificate in Law (CL)- Main Campus 3 SCHOOL OF BUSINESS Diploma in Accountancy (DA)- Mbeya Campus Diploma in Business Management (DBM)- Mbeya Campus Diploma in Logistics Management (DLM)- Mbeya Campus Certificate in Accountancy (CA)- Mbeya Campus Business Management Course (BMC)-Main Campus Certificate in Local Government Finance (CLGF)- Main Campus Certificate in Logistics Management (CLM)- Main Campus 4 FACULTY OF SCIENCE AND TECHNOLOGY Diploma in Applied statistics (DAS)- Main Campus Diploma in Information Technology (DIT)- Main Campus Certificate in Information Technology (CIT)- Main Campus Certificate in Applied Statistics (CAS)- Main Campus Certificate in Library and Information Management (CLIM)- Main Camus preferenc e 7. Do you have any physical or communication disabilities? (Tick whichever is applicable) (a) Vision/Mobility/Hearing/Others (b) If any of the above give details of disability 8. DECLARATION I declare that all information given on this form is true and correct to the best of my knowledge. SIGNATURE OF APPLICANT: Date: 9. EMPLOYER S /SPONSOR APPRAISAL HIGH NORMAL LOW Rating of Applicant Knowledge of job being done Knowledge of whole organization Ability to learn Initiative to learn Co-operation Judgment/Common sense 10. EMPLOYER S RECOMMENDATIONS: (If any ) 11. Name and address of Employer (OFFICIAL STAMP) Signature: (DATE) 4

5 12.SPONSOR S DECLARATION (To be completed by Private Sponsors) I hereby accept the responsibility of paying the fee and other charges for the applicant. Full Name and Address of Sponsor: Signature: Date: NB: Important Attachments i. Certified copies of relevant academic certificates ii. NECTA equivalence translations ( for those with foreign Secondary certificates) iii. Certified copy of Birth Certificate iv. Original Bank Pay-in-slip of Application fee. v. Affixed colored recent photo Please return the complete application forms to: The Admissions Office Tel: /4 Mzumbe University Fax: P.O.BOX. 1 Mobile: Mzumbe admisson@mzumbe.ac.tz TANZANIA website: 5