Postgraduates Form - University Of Eastern Africa, Baraton Page 2

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9. Provide the names of three referees who can completely comment on your character and ability to pursue post graduate studies. Two of
them must come from the College or University last attended, and the third one from your Religious leader or place of work or profession.
Names and Addresses of three referees:
1.
_________________________________________________________________________________________________________________________
2. ___________________________________________________________________________________________________________________________
3. __________________________________________________________________________________________________________________________
PART 3 EDUCATIONAL BACKGROUND Please list High/Secondary School, Colleges and Universities that you have attended
Institution
Country
From: Month/Year
To: Month/Year
Degree Classification
PART 4 EMPLOYMENT RECORD
From
To
Employer
Position/ Experience
PART 5 CAREER/PROFESSIONAL OBJECTIVES
Explain your educational goals, career objectives, work experience, awards, and/or extracurricular activities. Write in a paragraph
form (preferably type-written) on a separate sheet of paper and submit as supporting document.
APPLICANT’S CERTIFICATION
I hereby certify that all information supplied by me in this application is accurate and complete, I understand that any misrepresentation of
fact will constitute cause for nullification of my application prior to admission or dismissal following admission. I have attached the following
supporting documents to this application form
:
(tick those that apply to you)
1. official receipt of application fee payment (US $30.00)
2. certified photocopies of college or university diplomas or degree certificates
3. two recent passport-size photos
4. three letters of recommendation from referees in sealed envelopes
5. two certified copies of official transcript from each college/
university attended (certified by the institution or Commissioner of Oath)
6. certified photocopy of secondary school certificate
7. updated curriculum vitae (CV)
8. essay (response to Part 5 of this form)
9. certified copy of current practice license (for MScN applicants only)
APPLICANT’S SIGNATURE: ______________________________________________ DATE: __________________________________________
Important: If a document is written in a language other than English, please submit a certified copy of the document in the original language and
its translated version in English. Incomplete supporting documents will cause delay in the admission process.

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