Non School Leaver Application Form 2023

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DIVINE WORD UNIVERSITY

P O Box 483 Madang, Papua New Guinea


Tel: 422 2937 Website: www.dwu.ac.pg

THIS FORM MUST NOT BE FAXED/EMAILED IN


NON SCHOOL LEAVER APPLICATION 2023
 All Non-School Leaver Application need to be accompanied by a K100.00 Administration Fee
Refer to the 2023 Program Information and Entry Requirements before you attempt to complete this form.
PART 1. PERSONAL INFORMATION:
First Name: Surname:
Gender: DOB: Day Month Year Home Province:
Village: District:
Are you a PNG citizen? YES: ( ) NO: ( ) Religious Background:
Mother’s Occupation: Father’s occupation:
Last school attended: Tick appropriate range of your family income per annum:
(K0-5,000 ) (K5,000-14,000 ) (K14,000 and over per Annum )
Tel:
Your Current Postal Address: Now residing in:

Nearest Airport:

Your Telephone/Mobile No: Your Reliable Email Address:


Fax No: Ask for:

I wish to apply for Tertiary Studies in: (Please tick ONLY ONE Bachelor program of your choice). If you are applying
for more than one program, you will need to complete a separate NSL application form and pay separate the
application fee.
ARTS & SOCIAL SCIENCES MEDICAL & HEALTH SCIENCES
 Communication Arts (Journalism)  Environmental Health
 Arts (PNG Studies & International Relations)  Rural Health
 Arts (Social and Religious Studies)  Health Management
 Arts (Social Work)  Physiotherapy
 Medicine & Surgery (MBBS)
BUSINESS & INFORMATICS  Advanced Diploma in Eye Care
 Business Studies (Accountancy &
Management)
EDUCATION
 Information Systems
 St. Benedict’s – Wewak
 Tourism & Hospitality Management
 OLSH Kabaleo - Rabaul
 Mathematics and Computing Science
PART 2. ACADEMIC INFORMATION:
Refer to the Information for Applicants to ensure that you meet the entry requirements for the program applying for.
Which academic qualifications do you have to support your application? Enter your results in the space near subjects taken.

Year Institution Results


Grade 10 English Maths Science Social Science
Grade 12 L&L Maths A Maths B Biology
Chemistry Physics Geography Economics
History Business Studies Computer Others
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Post Grade 10 / Tertiary study

Course studied Institution Academic Qualifications Year

Please attach the following documents:

 Copy of results of Grade 12 or of Matriculation studies - must be certified as true copy of the original. Any
documentation not properly certified will result in your application not being assessed / processed.
 Transcripts of any further study must be submitted before the due date
 References or letters as required by individual departments (see General Information for Applicants).

N.B. Original certificates will be sighted at registration if selected.

PART 3. WORK EXPERIENCE:


Employment record: List your most recent position first

Date Employer Address Position / Responsibilities

This section to be completed by COMMUNITY OR RELIGIOUS LEADER:


Comments on applicant’s involvement in local church activities, witness to faith, and suitability for tertiary study at DWU:

Name: Position:

Signature: Date:

PART 4. FEES:
Who will be paying your fees? Tick the appropriate box.

□ Self □ Sponsor – Name your Sponsor _____________________________________________________

Refer to current 2022 DWU Fee Schedule via the DWU website for fee information and to prepare accordingly. Fees are
subject to change.

Applicant’s Signature: Date:

Non-School Leaver Applications must be returned by 31 August, 2022


All Non-School Leaver Applications must be accompanied by a non-refundable Administration Fee of K100.00 The
application form will not be processed if this payment is not made. This Fee is to be paid into the BSP A/c No.1000 433806,
Madang Branch and the receipt should be attached to this Application.

Return this form to: The Registrar, Divine Word University, PO Box 483, Madang, Madang Province
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