Application form fee: K 120 (Non Refundable) FULL TIME: Attach two (2) Passport Photos PART TIME: DISTANCE LEARNINIG: APPLICATION FORM FOR ADMISSION

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1 Application form fee: K 120 (Non Refundable) FULL TIME: PART TIME: Attach two (2) Passport Photos DISTANCE LEARNINIG: APPLICATION FORM FOR ADMISSION Note: Completed application form must be submitted to the Registrar, Linksfield College of Science and Technology. All payments must be deposited into Linksfield College of Science and Technology, Account Number , Woodlands Branch, ZANACO Bank. A copy of a Bank Deposit Slip should be presented to Accounts section upon which an official receipt will be issued. 1. PERSONAL DETAILS (COMPULSORY) Surname: Other Names: NRC No. : / / or Passport No. (For Non- Zambians): Nationality: Sex: Male Female Date of Birth: / / Marital Status: Married Single Postal Address Residential Address: Phone Number: Address: Town: District:

2 2. Mark the channel of communication that Led you to choose Linksfield College i. Brochure ii. iii. Friends TV iv. Others Specify : 3. Names and address of Parent / Guardian / Sponsor (Tick YOUR CHOICE) Name of Guardian : Phone No. : Home Address : 4. Do you have any Physical Disabilities (Tick): Yes No Tick the disability applicable : Vision / Speech / Hearing / Mobility (Legs) / Others (Name of disability: ) 5. EDUCATTION a. Schools Attended Schools attended Year of exams Examining body Grades Level ( O or A ) Please attach copies of your certificate (s) or statement of results (s) to your application form

3 6. UNIVERSITY OR COLLEGE University or Date of attendance college from and to Qualification Major Class or Grade Please attach copies of your certificate (s), diploma, degree or transcript (s) to your application form Any other relevant qualification and or experience. 7. PROGRAMME PREFERENCE (Tick) Medical Foundation Programme (Pre - medics): GCE O Levels A Levels EDUCATION 1. Secondary Teachers Diploma 2. Primary Teachers Diploma 3. Early Childhood Teachers Diploma 4. Teaching methodology Diploma BUSINESS STUDIES DIPLOMA 1. Purchasing and supply 2. Business administration

4 3. Human Resource Management 4. Accounting and Finance 5. Public Administration 6. Banking & Finance 7. Sales & Marketing INFORMATION AND COMMUNICATION TECHNOLOGY (ICT) 1. Certificate in Computer Studies TEVETA 2. Advanced Certificate in Computer Studies - TEVETA 3. Diploma in Computer studies - TEVETA 4. Certificate in Computer Systems Engineering - TEVETA 5. Diploma in Computer Systems Engineering TEVETA ICT SHORT COURSES - CERTIFICATE SOCIAL SCIENCES DIPLOMA 1. Development Studies 2. Social Work HEALTH SCIENCES DIPLOMA 1. Registered Nursing 2. Clinical Officers General 3. Public Health 4. Environmental Health Technology 5. Psych & Social Counseling 8. SPONSORSHIP INFORMATION Please indicate how you intend to finance the cost (tuition fees, mandatory fees and living expenses) of your proposed course of study Self-sponsored Parents / Guardian Government Company / NGO Ministry:. Specify..

5 9. FOR OFFICIAL USE ONLY : a. A duly completed application form b. Copies of my school certificate, transcript, or other documents c. NRC/Passport d. Letter of sponsorship 10. DECLARATION BY APPLICANT I certify that the information provided by me is correct to the best of my knowledge and that no relevant information has been withheld. I understand that any or all of this information may be verified in order to process my application. I also agree that I will abide by all college rules, regulations and policies if I am admitted into Linksfield College of Science and Technology. Students name in full (in block letters): Signature: Date:..