University of Malawi

UNIVERSITY OF MALAWI

Tel: (265) 01874 828/01 873 724 Fax :(265) 1 873 895

e-mail: (265) 1 870 578

PRELIMINARY APPLICATION FORM

CIM ON-LINE (POSTGRADUATE DIPLOMA) COURSE

1. PERSONAL DETAILS

Surname (Mr/Mrs./Ms/Dr/Prof/Rev) ………………………………………………………..........

First Names……………………………………………………………………………………………

Address for correspondence…………………………………………………………………………

……………………………………………………………………………………………....................

Tel………………………………….. Fax……………………………………………………………..

Cell………………………………………. E-mail…………………………………………………….

Subjects (Please tick) (a) Emerging themes

(b) Analysis and Decision

(d) Managing Corporate Reputation

2. ACADEMIC QUALIFICATIONS

Highest academic achievement…………………………………………………………………………

Highest professional achievement …………………………………………………………………….

……………………………………………………………………………………………………………….

3. EMPLOYMENT

Name of present employer……………………………………………………………………………..

Employer’s Address……………………………………………………………………………………...

Employer’s Telephone Number………………………………………… Fax ……………………….

Applicant’s position………………………………………………………………………………………

Length of time on the post………………………………………………………………………………

4. FEES

Who is paying for your tuition fees?.............................................................................................

(Where employers are paying directly, a letter confirming this should be attached to the application)

5 APPLICANT’S SIGNATURE ……………………………………………………………………

DATE………………………………………………………………………………………….…..

SEND THIS COMPLETED FORM TO THE DIRECTOR USING THE ABOVE ADDRESS