Centre for foreign relations dar es salaam
Yüklə 64,48 Kb.
|
- Bu səhifədəki naviqasiya:
- CENTRE FOR FOREIGN RELATIONS DAR ES SALAAM APPLICATION FOR ADMISSION FOR ACADEMIC YEAR 2017/2018 PROPOSED STUDY
- 4. EDUCATION QUALIFICATIONS
- SUBJECT MARKS DATE INDEX NO. POINTS
- SCHOOL/CENTRE OTHER QUALIFICATIONS
- PROGRAMME CLASSIFICATION DATE COLLEGE/UNIVERSITY
- 5. LANGUAGE PROFICIENCY
- 6. EMPLOYMENT EXPERIENCE
- 7. EXTRA CURRICULAR ACTIVITIES: (i) …………………………………. (ii) ………………………………… (iii) ………………………………… 8. DISABILITY/SPECIAL NEEDS
- APPLICATION SUBMISSION
- CENTRE FOR FOREIGN RELATIONS DAR ES SALAAM REFERENCE TO SUPPORT APPLICATION FOR ADMISSION
- SECTION 2: To be completed by a referee
- CENTRE FOR FOREIGN RELATIONS DAR ES SALAAM MEDICAL REPORT
- ELABORATE ON POSITIVE FINDINGS
  
CENTRE FOR FOREIGN RELATIONS DAR ES SALAAM APPLICATION FOR ADMISSION FOR ACADEMIC YEAR 2017/2018
Post graduate Diploma in Management of Foreign Relations: Evening Post graduate Diploma in Economic Diplomacy: Evening Bachelors Degree in International Relations and Diplomacy: Regular/Evening Diploma in International Relations and Diplomacy: Regular/Evening Certificate in International Relations and Diplomacy: Regular/Evening 2. PERSONAL DETAILS: SURNAME ……………………. FIRST NAME ……………………... MIDDLE NAME ……………………. DATE OF BIRTH ………………………………………. . NATIONALITY ……………………………………. MARRITAL STATUS Married Single Widower NAME OF NEXT OF KIN ……………………………………. RELATIONSHIP ………………………………. OCCUPATION ………………………………………………………. 3. ADDRESSES: PERMANENT ADDRESS ……………………………..…………………………………………………………. TELEPHONE …………………………… E-mail ……………………………………… PRESENT ADDRESS ……………………………………………………………………………………………… TELEPHONE ………………………………………………………. E-mail ……………………………………… ADDRESS OF NEXT OF KIN ……………………………………………………………………………………...
A-LEVEL (WRITE ONLY SUBJECTS WITH Principals and Subsidiary)
OTHER QUALIFICATIONS: (Degree, Advanced Diploma, Diploma, Certificate)
5. LANGUAGE PROFICIENCY: Indicate proficiently level estimate (e.g. excellent, good, fair, poor)
6. EMPLOYMENT EXPERIENCE:
7. EXTRA CURRICULAR ACTIVITIES: (i) …………………………………. (ii) ………………………………… (iii) ………………………………… 8. DISABILITY/SPECIAL NEEDS: The Centre realizes that some members of the community have special needs. The information you provide will not affect judgments concerning your academic suitability and will be treated confidentially. Do you have a disability YES NO If yes, please provide further details in the space below:- ……………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………… 9. REFERENCES: Please give two names of your Referees
Address ……………………………………………………………………………………………………
Address …………………………………………………………………………………………………… 10. DECLARATION In the event of, and in consideration of the Centre accepting me as a student, I hereby undertake to pay, as and when due all Centre fees. I understand that the payment of tuition fees be made in advance or at registration. I certify that I enjoy good health and that I am not now suffering from any disease likely to interfere either with studies or with the health of other students. I hereby certify that all the above information is correct and complete, and I desire to apply for admission as a student of the Centre and declare that, if admitted, I undertake to conform to all the Rules and Regulations of the Centre for Foreign Relations. Signature of the applicant………………………………….. Date……………………………………………..… APPLICATION CHECK LIST This application form should be returned accompanied with: Certified copy of Certificates, Diplomas or University degrees 4 passport size recent photographs Receipt of 30,000/= (for application-) Letter of confirmation for Sponsorship Medical Report Form
This form should be completed and returned on or before Monday, 31st July, 2017 to: Deputy Director Academic, Research and Consultancy Centre for Foreign Relations P.O. Box 2824
SECTION 2: To be completed by a referee The above-named is applying for admission at this Centre, and has named you as an academic referee. The Centre would be grateful if you could complete this form and return it in the enclosed envelope, to the applicant as soon as possible. 1. Name of referee: ………………………………………………………….......................................... 2. Designation: ………………………………………………………………………………………….. 3. Address: ……………………………………………………………………………………………… 4. Telephone: ……………………………………e-mail……………………………………………….. 5. How long and in what capacity have you known the applicant …………………………………….. 6. If the applicant’s first language is not English please comment on the level of competence.
Outstanding Above Average Average Below Average 8. In your opinion, to what extent does the applicant posses intellectual, practical and personal abilities that are required to cope with the Centre’s grueling programmes? Signature: ……………………………………….. Date: ………………………... 
CENTRE FOR FOREIGN RELATIONS DAR ES SALAAM MEDICAL REPORT FULL NAME: ………………………………………………………………………………………………………………… SEX: …………………………………………….. AGE: …………………………………………………………………… HEIGHT: ……………………………………….. WEIGHT: ………………………………………………………………. Medical Examiner is requested to provide categorical answers to the following:- YES NO YES NO
17. Eye:- Conjunctive ……………………………………………. Pupils ………………………………………. Sight: Without Glasses Right ………………………………………. Left ……………………………... With Glasses Right ………………………………………. Left ……………………………... 18. Respiratory System …………………………………………………………………………………………………... 19. Cardio Vascular …………………………………….. Pulse ………………............................................................... Blood Pressure: Systolic ……………………………… Diastolic …………………………………………………... 20. Any clinical evidence of hyperacidity or gastric ulcer ……………………………………......................................... 21. BLOOD VDRL ………………………………… Haemoglobin …………………………. Leucocytes ……………………. Neutrophils ……………………………………….. Lymophocytes ……………………………………………….. Resophil…………………………………………… Eosmophiles ………………………………………………….. Monocytes …………………………………………. Blood Group ……………………………………………….
The heart size ………………………………………………………………………………………………………… The lung field ………………………………………………………………………………………………………… Thoracic cafe …………………………………………………………………………………………………………. Conclusions …………………………………………………………………………...................................................
I certify that MR/MRS/MISS …………………………………………………………………………………......................... Is FIT/UNFIT to undertake studies at the Centre for Foreign Relations, Dar es Salaam. (cross whichever is appropriate in). DATE: ………………………………………………………………………………………………………………………… PLACE: ………………………………………………………………………………………………………………………... MEDICAL EXAMINER’S SIGNATURE: ……………………………………………………………………………………. QUALIFICATIONS: ………………………………………………………………………………………………………….. ADDRESS: ……………………………………………………………………………………………..................................... TELEPHONE: ……………………………………………………………………… Yüklə 64,48 Kb. Dostları ilə paylaş:
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
