Sokoine University of Agriculture: Office of The Deputy Vice Chancellor (Academic)

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SOKOINE UNIVERSITY OF AGRICULTURE

OFFICE OF THE DEPUTY VICE CHANCELLOR (ACADEMIC)


P.O. Box 3000, CHUO KIKUU, MOROGORO PHOTO
TANZANIA
Tel. +255-23-2603511/4, Dir. +255-23-2603236; Fax. +255-23-2604652
E-mail: dvc@suanet.ac.tz or admission@suanet.ac.tz, dvc.academic@yahoo.com

REGISTRATION FORM FOR UNDERGRADUATE CANDIDATES

1. SURNAME (UPPER CASE LETTERS).

2. FIRST NAME IN FULL (UPPER CASE LETTERS)

3. MIDDLE NAMES IN FULL (UPPER CASE LETTERS).

4. DEGREE PROGRAMME

5. REGISTRATION No.
NOTE: The name in which you will be registered shall be that which appears on your National form VI School Certificate or equivalent document
Put [ ] in the respective bracket

6. Date of Birth: / / / 7. Place of Birth: (Town or District and Country)

8. Religion: 9. Marital status: Married [ ] Single [ ]

10. Sex: Male [ ] Female [ ] 11. Citizenship: 12. Country of Residence:

13. Contact Address 14. Employers Name


Physical Address Contact Address
Email Address Telephone No:
Mobile No. Email Address:

15. Name of next of kin:


Occupation:
Relationship: Email Address:
Full address: Fax No.:
Tel. No.: Mobile No.:

16. Give details of further courses of study (if any) Name of Award Grade attained (Dist. Credit, Pass):
1. Certificate
Institution
2. Diploma
Institution

17. Do you have any communication disabilities? YES/NO (if any indicate the disability.)

18. Category of studentship (tick the appropriate one):


(i) Direct entrant (using A level qualifications)
(ii) Equivalent student
(iii) Mature Age Entrant

19. Have you been officially released by your employer? YES/NO (where applicable) If yes, attach the documentary evidence
20. Financial Sponsor
Name of Sponsor:
Address of Sponsor

21. Do you have any medical disability/problem? YES/NO (indicate the problem if any .. (attach evidence)

22. What are your extra curricular activities? Indicate


23. STATEMENT BY APPLICANT:
I certify that the information given above is true and correct to be best of my knowledge.

Signature of Applicant: Date:

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