COLLEGE OF BUSINESS EDUCATION DAR ES SALAAM/DODOMA/MWANZA

APPLICATION FORM TO ATTEND PRE-ENTRY FOR BACHELOR DEGREE COURSES 2013/2014

No: ------

BACHELOR DEGREE IN BUSINESS ADMINISTRATION (BBA), ACCOUNTANCY

(BACC)/PROCUREMENT&SUPPLIES (BPS), MARKETING (BMKT), LEGAL AND INDUSTRIAL METROLOGY (BMET)

FULL TIME / NIGHT COLLEGE 2013 BBA/BACC/BPS/BMK/BMET (Underline the course and Session of your choice) The Rector College of Business Education P.O. Box 1968 Dar es Salaam. NOTE: a) b) c)

AFFIX PHOTO PASSPORT SIZE

Applicant must affix a photograph on the space provided. Application form without a photograph will not be considered. This form when completed must reach the Rector by 12TH July, 2013 Every applicant must pay a non-refundable application fee of Tsh.25,000/= through Bank as indicated below: Dar es Salaam Campus: NMB A/C No. 2061100030 Dodoma Campus: NBC A/C No. 029101000711 Mwanza Campus: NMB A/C No. 3111100092

1. 2.

SURNAME: (Block Letters)..

First Names in Full (Block Letters) NOTE: The names entered in this form must be the same as those on your official Academic certificates. 3. 4. 5. Date of Birth . Place of Birth Nationality ..By Birth By Registration No.DatePlace 6. Present Address .Tel./Mobile 1

7. 8. 10. 11. 12. 13. 14. 15.

Permanent Home Address Religion .. Marital status Number of Children.. Present Employer.. Employed as.. Salary scale .. Have you ever been convicted of a Criminal Offense? YES/NO If yes give details

16. 17.

Disability/Special needs. State of health.. EDUCATIONAL QUALIFICATIONS

PART II

18. School(s) and College(s) attended School or Colleges Attended Types: Primary/Secondary Certificate obtained and Dates

(Use a separate sheet if space is insufficient)

19. Professional/sub-professional Qualifications Body NABE, NBAA, NBMM etc. Stage completed Certificates obtained and Dates

Notes: It is important that copies of the following documents (NOT ORIGINAL) are attached:
Application form without copies of certificates will not be considered. Also submission of forged certificates or any false information is criminal offence and will be dealt with according to the law. (a) (b) (c) (d) National Form Four Examinations Certificate School Leaving Certificate Birth certificate. Any other relevant certificates supporting qualifications stated under No.18 and 19.

PART III 20.

PREVIOUS EMPLOYMENT RECORDS

Particulars of your employment since leaving School or College including periods of training, apprenticeship, self-employment or unemployment. Name and Full Address of Employer From (Month and Year) To (Month and Year) Position(s) Held

PART IV

FINANCIAL STATUS

21. Course fees will be paid by a) b) My employer (Name).. Any other sponsoring organization or person (Name). Note: If you have ticked (a) or (b) please ask your prospective sponsor to Complete No. 22. 22. EMPLOYERS/SPONSORS CERTIFICATE (To be completed by a responsible officer authorized by the Organization/Family) (a) We.. approve sponsorship of the above applicant and hereby confirm that he/she will be released (from employment etc) for the purpose of attending the course for the whole of the required period. We further confirm that our Corporation/Company/Family/Organization/ Ministry will sponsor the applicant if accepted, and pay the College fees as indicated on the attached sheet, and as may be amended, from time to time. We also undertake to confirm that the applicant is physically fit and that he/she has no criminal records to the best of our knowledge. Signed Name Rank. On behalf of . Any other comments.. I CERTIFY THAT THE INFORMATION GIVEN ABOVE IS CORRECT.

(b)

APPLICANTS SIGNATURE

DATE