JIMMA UNIVERSITY FORM-A SGS/07(2 Copies)

OFFICE OF THE REGISTRAR

Application form for Graduate Program
Attach here your recent passport size
Admission
photograph showing your full face

Instructions
1. PRINT ALL INFORMATION - USE BLOCK LETTERS
2. COMPLETE APPLICATION IN TWO COPIES
3. SUBMIT THE FOLLOWING ALONG WITH THE APPLICATION:
 Original degree with two photocopies
 A receipt of Birr 200.00(Two hundred Birr) for 2nd degree applicants and 400.00 (Four Hundred Birr) for 3 rd degree applicants
application fee
 2 recent pass port size photographs
Letter of sponsorship (Form-C SGS/07) completed and signed by the head of your organization. Or completed self sponsorship
form.
 Letter of Recommendations of Form-B SGS/07 that can also be mailed directly to the office of the Registrar by your references.

NOTE
i. Application must be submitted not later than October 01, 2021.
ii. Letter of sponsorship (Form-C SGS/07) should be completed and signed by the Federal or Regional Government offices. If
the sponsoring organization is nongovernmental, it is mandatory to make the payment of the tuition cost ahead.

Applied to:
College & Department________________________________________________________________
Program Name____________________________________________________________________

Admission type (Please mark in the appropriate box) Regular Evening Weekend Summer

PERSONAL INFORMATION
1.1. A) Full name (in Amharic) -------------------------- ----------------------- -------------------
(in English) ------------------------- ------------------------- ---------------------
First Name Father's Name Grand father's Name
1.2. Sex: Male  Female 
1.3. Date of Birth: (E.C) ------------------------- ---------------------- -----------------------
(G.C) ------------------------ ----------------------- -----------------------
Day Month Year
1.4. Place of Birth: Town ---------------------------------- Region ----------------------------
1.5. Your Mother's Full Name: ----------------------------
1.6. Nationality: ---------------------------------------------
1.7. Marital Status: Single  Married  Divorced  Widowed 
1.8. Present Address: Kebele ____________ Woreda ___________ House No.___________
Town _____________ Region ____________ P. O. Box ___________
Telephone No: Home ___________________ Office ______________
1.10. Name, relationship & address of person to be contacted in case of emergency
Name ______________________________________________________Tel. No.__________________
II. EDUCATION AND PROFESSIONAL EXPERIENCE
2.1 EDUCATION
 Secondary school
Period
Name of the institution Address
(dd/mm/yyyy-dd/mm/yyyy)

 Tertiary education
(In reverse chronological order, starting with the most recent study)
Period Name of the Type of diploma or Grade/
Name of studies
(dd/mm/yyyy-dd/mm/yyyy) institution certificate obtained results

2.2. PROFESSIONAL EXPERIENCE

(List in reverse chronological order, starting with your current job)
Name and address of employer Period Position and description of responsibilities

III. RESEARCH
Give particulars of any relevant experience in research. Give references to any published work you have
done. Enclose if possible.
____________________________________________________________________________________
____________________________________________________________________________________
VI. FINANCIAL SUPPORT

Government Organization sponsored

Non-government organization sponsored
Self- Sponsored
a) If government or non-government organization sponsored, give name and address of the Organization
sponsoring your graduate study. Form-C SGS/05 should be completed and duly signed by your sponsor and
submitted to the Registrar with your application.

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 ____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
b) If self sponsored, a statement of financial evidence should be attached indicating that your financial
Position, or that of your family, is adequate to cover all the tuition and other fees for the whole period of Study
at Jimma University. Form-D SGS/07 should be completed and duly signed by you and submitted to the
Registrar with your application.

I, hereby, certify that all information given in this document is complete and accurate. I will observe all the
rules and regulations of the institution and declare that I will refrain from any activity, which is contrary to the
interest of the institution.

Date ________________________ signature of Applicant ____________________

For official use only
TO BE COMPLETED BY THE CHAIRMAN OF FACULTY ACADEMIC COMMISSION
RECOMMENDATION: Admitted Not admitted

Name of Advisor: ____________________________________

Date ______________________ Signature ________________
Chairman, Faculty Academic Commission
(Please attach minutes of the FAC to the application)

ACTION BY COUNCIL OF GRADUATE STUDIES

Approved
Not Approved

Date _________________ Name _________________ signature _______________

Dean, school of Graduate studies

(Please attach the AC minute to the application)

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 JIMMA UNIVERSITY FORM-B SGS/07
OFFICE OF THE REGISTRAR (2 Copies)
Application form for Graduate Program
Admission

Letter of Recommendation for Graduate Program Applicants

FULL NAME OF THE APPLICANT __________________________
DEGREE SOUGHT ____________ PROPOSED FIELD OF STUDY ______________
The above-mentioned candidate has applied for admission to the School of Graduate of Jimma University. The
office of the registrar will greatly value your assistance in helping the candidate. Please kindly supply genuine
answers to the following questions. The information provided will be confidential. Please mail the completed
form directly to: OFFICE OF THE REGISTRAR
JIMMA UNIVERSITY
P.O. BOX 378
JIMMA, ETHIOPIA
TO BE COMPLETED BY RECOMMENDER:
I. HOW LONG HAVE YOU KNOWN THE APPLICANT?
II. IN WHAT CAPCITY HAVE YOU KNOWN THE APPLICANT?
TEACHER OR PROFESSOR __________ EMPLOYER OR JOB SUPERVISOR _________
RESEARCH ADVISOR _______________ OTHER (PLEASE SPECIFY) ______________
III. PLEASE PROVIDE AN EVALUATION OF THE APPLICANT`S PAST
PERFORMANCE AND ABILITY TO PURSUE AND SUCCESSFULLY COMPLETE A PROGRAM
OF STUDY IN THE PROPOSED FIELD
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________

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 IV. IN THE RATING CHART BELOW, PLEASE EVALUATE THE
APPLICANT IN COMPARISON WITH OTHER STUDENTS WHOM YOU HAVE KNOWN DURING
YOUR PROFESSIONAL CAREER.
Excellent Good Fair Poor Unable to judge
Research ability
Command of filed of study
Written English
Oral English
V. PLEASE INDICATE WHERE THE APPLICANT WOULD RANK AMONG
STUDENTS CURRENTLY IN YOUR DEPARTMENT.
Blew Average Some what Good Unusual Outstanding Truly Inadequate
Average average Exceptional opportunity to
observe
Lowest Middle 60-74% 75- 90-100%
40% 45-59% 89%

VI. PLEASE TICK AS APPROPRIATE:

I recommend this applicant strongly
I recommend this applicant
I recommend this applicant with reservation
I do not recommend this applicant
Name and Title (Print) ------------------------------------------------------------------------
Institutional affiliation or Business firm if applicable _______________________
_____________________________________________________________________
signature ________________________________ Date ________________________
Please put in a sealed envelop, stamp and send to the above address. Its confidentiality will be respected
by Jimma University.
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 JIMMA UNIVERSITY FORM-C SGS/07
OFFICE OF THE REGISTRAR (3 Copies)
Application form for Graduate Program
Admission

Letter of Sponsorship for Graduate Study

(To be filled out and signed by the Head of the Organization)
OFFICE OF THE REGISTRAR
JIMMA UNIVERSITY
P.O. BOX 378
JIMMA, ETHIOPA
On behalf of_____________________________________________________________organization of
which I am a head, I am committing the said organization to cover all the costs to
_____________________________________ in the course of his/her postgraduate training in
__________________________________________. The financial support which is intended to cover both the
tuition fee and living expenses of the graduate student will be maintained until the termination of the program of
study. Moreover, I express the organization’s agreement to refrain from compelling the candidate to undertake
extra work assignments, which may jeopardize his/her program of study.

I am cognizant of the fact that the concrete realties of the country dictate that education in general, and
postgraduate studies in particular, must be geared towards the solution of specific problems affecting the
society. I am, therefore, aware that this specific training which my organization is sponsoring must be geared
towards fulfilling a definite national purpose. Accordingly, through my signature affixed below, I am
committing my organization to cover the tuition fee and also any other costs entailed to the study and maintain
an appropriate position of employment for the candidate after the completion his/her study.

Date: _______________________ Signature: ___________________ Office seal ________

Name ___________________________
Position: _________________________
Organization: _____________________ Address: _____________________

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 JIMMA UNIVERSITY FORM-D SGS/07
OFFICE OF THE REGISTRAR (2 Copies)
Application form for Graduate Program
Admission

Self sponsorship Form

From Graduate Study
(To be Filled out and signed by the applicant)
Name of the applicant _____________ _________________ _______________
Employer/ Institution______________Region________Zone__________City/Town___________
Program intended to join ____________________
I, the undersigned candidate, firmly agree to fully sponsor myself and pay the entire necessary tuition fee if I
secure admission and abide by the academic rules and regulation of Jimma University.

Signature_________________ Date ___________