A3 Institute Application For Admission

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KSIJ - Central Board of Education
A P P L I C AT ION F OR AD MISS IO N
Privacy & Data Protection Statement
Contact Information
By signing this form you are consenting to the A
3
Institute of Professional Studies using the information provided from time to time,
Campus Address
along with any further information about you that the Institute may hold. The information that you provide on your application form
Jaffery Complex
may be used for the following purposes:
P. O. Box: 21735
To enable your application for entry to be considered and allow our Admin Office, where applicable, to assist you through the
Next To Umoja Wa Vijana Building
application process;
Morogoro Road
To enable the Institute to compile statistics, or to assist other organisations to do so.
Dar es Salaam
To enable the Institute to initiate your student record should you be offered a place at the Institute.
For any other purpose, event and issue that the institute feels appropriate.
A
3
Institute of Professional Studies shall ensure that all such information is used in the best interests of the students and the
Phone
+255-22-2152167
:
Institute.
+255-22-2150162
Fax:
+255-22-2152167
Instructions
Cell:
+255-655-026923
+255-777-026923
Complete all sections of the Application for Admission form
Print clearly in BLOCK letters
Email: director@a3.ac.tz
If you wish to apply for more than one course, you must submit a separate Application for Admission form for each course.
Web:
This Application For Admission form, together with the Application Fee, to be submitted to the Admin Office of the Institute.
APPLICATION NO. ___________________________________
1
Personal
Title
Mr
Mrs
Ms
Miss
Dr
First Name
Date of Birth:
Enter names exactly as they appear on official documents
Affix Recent Photograph
Last Name
Address
Town/City
P. O. Box
Telephone
Email
Parent / Guardian’s Name
Parent / Guardian’s Telephone
Last School / College Attended
Form/Qualification
Year Completed
Attach appropriate transcripts, testimonials and certificates to this
Application
2
Programme / Course
Programme / Course Name
Timings
Full Time
Morning Batch
Evening batch
Module(s) / Paper(s)

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