University Of Dar Es Salaam - Application Form For Admission To Postgraduate Programmes Page 2
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4PLEASE MAKE SURE THAT THIS FORM IS CAREFULLY AND FULLY COMPLETED.
THE PERSONAL INFORMATION COLLECTED ON OR IN CONJUNCTION WITH THIS
FORM IS REQUIRED TO DETERMINE YOUR ELIGIBILITY FOR ADMISSION AND WILL
BE USED TO CONTACT YOU REGARDING UNIVERSITY PROGRAMS AND SERVICES.
IT WILL FORM PART OF YOUR RECORD AS AN APPLICANT, STUDENT AND
ALUMNUS. WE LOOK FORWARD TO RECEIVING YOUR APPLICATION
Biographical Information
Surname/Family Name
Other Name(s)
Title:
Date of
Country of
Nationality
Disabilities/Spec
(Mr/Mrs/Miss/Ms)
Birth
Birth
ial needs
Yes
No.
Permanent Address
Nature of Disability/special needs (if any)
Telephone Numbers
Fax Number
E-mail Address
•
Land line
•
Mobile
Employment Record
Institution (current Employer)
Position:
From:
To:
Nature of Work (Responsibilities) (You may use a separate sheet)
If you are admitted into our Postgraduate Programme, do you think your employer will release you? Tick
Yes ( ) No ( ) If Yes provide evidence.
Academic Information
Highest Academic
Institution
Year of Graduation
Qualifications Attained
Specialization
Undergraduate/Advanced/Postgraduate Diploma GPA
Other Academic or Professional Qualifications
PLEASE NOTE THAT STUDENTS SHALL BE REGISTERED BY NAMES APPEARING ON
THEIR CERTIFICATES AND APPLICATION FORMS. CHANGE OF NAMES SHALL NOT
BE ALLOWED DURING THE ENTIRE PERIOD OF STUDY.
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