ENROLMENT APPLICATION FORM

MLANDIZI ANGLICAN COMPUTING CENTRE

ENROLMENT APPLICATION FORM

1.      APPLICATION PARTICULARS

AGE GROUP 1-18                    19-25                    26 – ABOVE                        

COMPLETE NAME …………………………………………………………………………………………..

GENDER - MALE                 FEMALE              

DATE OF BIRTH ……………………………………

MARITAL STATUS ……………………………………………

NATIONALITY ……………………………………………….

EDUCATION LEVEL …………………………………………………………….. (E.g. primary/secondary)

OTHER TRAINING AND QUALIFICATION …………………………………………………………………… (Answer if any)

SPONSOR’S STATEMENT

I …………………………………………………………………………………………………… Here by agree to financially Sponsor Mr./Mrs./Miss ……………………………………………………………………..

Name of sponsor in full ………………………………………………………………………………..

Address of Sponsor ……………………………………………………………………………………

Tel No: …………………………………………………………….

Signature of Sponsor ………………………………………………………….

Date Of Signing …………………………………………………………………

Official stamp if any

Name of student in full

Signature of student

Date of signing ……………………….

PAYMENT PLAN

MODE	TICK
Full payment
Half payment

BALANCE OF FEES:

The remaining amount of fee will have be paid before the half of the course finished

RESIDENTIAL ADDRESS:

City/Municipality/Town: …………………………………………………..

Street name /Area: ……………………………………………………………..

Name of ward/ ………………………………………………………………….

Note: any payment made and receipted in respect of training costs shall not be refunded under any circumstance   .

APPLICATION FORM TSHS 3,000/=