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    2023 24 Undergraduate Application Form

    Uploaded by

    Hope Kholowa

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    2023 24 Undergraduate Application Form

    Uploaded by

    Hope Kholowa
    41 views3 pages

    Original Title

    2023-24-UNDERGRADUATE-APPLICATION-FORM

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    © © All Rights Reserved

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    41 views3 pages

    2023 24 Undergraduate Application Form

    Uploaded by

    Hope Kholowa

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 3

    2023-2024 Academic Year 1|Page

    UNDERGRADUATE APPLICATION FORM FOR NON -RESIDENTIAL DIPLOMA


    AND DEGREE PROGRAMMES
    Please tick the type of programme applied for: Attach your
    passport size
    a. Diploma [ ] d. Mature and Upgrading Programme [ ] photo here
    b. Economic Fee Paying [ ] e. Open Distance and e-Learning [ ]
    c. Extended Degree Programme [ ]

    PERSONAL DETAILS
    1. Surname:_____________________________________ First Name:___________________________________ Initials: ___________

    2. Date of Birth:_________/_________/___________ Sex: M [ ] F [ ] Nationality:__________________________________________

    3. Home District: _____________________________ T/A: ______________________________ Village: _________________________

    4. Contact Address:_____________________________________________________________________________________________

    Tel:__________________________Mobile: _________________________ Email:_________________________________________

    5. Next of Kin _______________________Address:____________________________________________________________________

    Tel:__________________________Mobile: _________________________ Email:_________________________________________

    6. Name and Address of Sponsor___________________________________________________________________________________

    Tel:__________________________ Mobile: _________________________ Email:________________________________________

    A. PROGRAMME APPLIED FOR

    1st Choice 2nd Choice 3rd Choice

    B. QUALIFICATIONS RECORD (Tick/Indicate appropriately)


    Strictly attach original academic transcript(s) and copy(s) of certificate(s)/statement of result(s) duly certified by a District
    Commissioner or any Commissioner of Oaths.

    i. Degree/Diploma: _____________________________________________________________________________________________

    School/ Board: _______________________________________________________Year Obtained____________________________ ii.


    High/Secondary school (Fill in the gaps below with the relevant information): MSCE [ ] IGCSE [ ]
    2023-2024 Academic Year 2| Page

    1st Attempt Grades 2nd Attempt Grades 3rd Attempt Grades

    Year: Year: Year:

    Centre name: Centre name: Centre name:

    Centre #: Centre #: Centre #:

    Candidate #: Candidate #: Candidate #:

    Subject (Highest to Grade Subject (Highest to Grade Subject (Highest to Grade


    Lowest) Lowest) Lowest)

    1. 1. 1.

    2. 2. 2.

    3. 3. 3.

    4. 4. 4.

    5. 5. 5.

    6. 6. 6.

    7. 7. 7.

    iii. Other Relevant Qualifications

    __________________________________________ Year ___________ School/Board ____________________________

    __________________________________________ Year ___________ School/Board ____________________________


    iv. Have you ever been registered as a student of any public University before or any other comparable
    institution elsewhere?

    If yes, when: _________________ Programme: ______________________________________ Institution: ____________________

    Reason for leaving your previous institution: ______________________________________________________________________

    C. CANDIDATES WITH SPECIAL NEEDS

    State any physical impairment you have and any special assistance/facilities that you require:__________________________________

    _____________________________________________________________________________________________________________________
    2023-2024 Academic Year 3| Page

    D. APPLICATION FEE E. SUBMISSION OF APPLICATION FORM

    All applicants are STRICTLY required to DEPOSIT a non- refundable application fee of K12,000.00 for Malawians and U$25.00 for
    international applicants to the bank details provided below. All relevant attachments and a duly filled in application form should be
    sent to the address given below: All applicants are being requested to indicate their names on deposit slip.

    The Registrar

    Bank Name National Bank of Malawi MUBAS

    Admissions Office
    Account Name Polytechnic Revenue Account
    Private Bag 303
    Account Number 737461
    Chichiri, Blantyre 3
    Branch Chichiri Branch

    F. CHECKLIST

    ITEM

    I confirm that I have duly completed all the relevant sections of this application form and attached the following supporting documents:
    1. Certified copies of all my relevant diplomas/certificates/academic transcripts/Statement from MANEB
    2. Original proof of availability of funds to finance your training i.e. official sponsorship letter or applicants bank statement(s)
    3. Copy of a bank deposit slip showing the name of the applicant and proof of payment of an appropriate application fee.
    4. Official reference letter(s) from the current and/or previous employer(s) showing proof of work experience (if necessary to this application.)

    G. DECLARATION

    I ______________________________________________________________________________________ hereby certify that all the


    information given on this form is true.

    Signature: __________________________________________ Date: _______________________________

    INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED!

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