MAHINYA TRAINING CENTRE
FOR SUSTAINABLE AGRICULTURE
P.O. Box 1282, Songea, Ruvuma, Tanzania
APPLICATION FORM FOR ADMISSION TO
“ANIMAL HUSBANDRY - LEVEL ONE PROGRAMME” FOR 2015 ACADEMIC YEAR
One copy of this form, when completed, must be sent to the COURSE COORDINATOR, MAHINYA TRAINING CENTRE FOR SUSTAINABLE AGRICULTURE, P.O.BOX 1282, SONGEA, RUVUMA TANZANIA, after paying a non refundable application fee of Tshs 15,000/= through Account No.01J1093812800 CRDB BANK - SONGEA BRANCH (ACCOUNT NAME: COPE SAAFI)
FOR OFFICIAL USE ONLY:
APPLICATION FEE RECEIPT No:______APPLICATION FORM No:______
APPLICANT MEETS ENTRY REQUIREMENT FOR______PROGRAMME
1.0 PERSONAL DETAILS
(Write in Capital Letter)
1.1 First Name:______Middle Name:______
Last Name:______SEX (M/F): ______
(The names entered in this form must be exactly the same as those on your C.S.E.E. or other academic certificates)
1.2 Date of Birth (Attach Copy of Birth Certificate):______Place:______
Country: ______Nationality: ______
1.3 Permanent contact address: ______
Tel. Home: ______Office: ______Mobile:______
E-Mail: ______
1.4 Name and Address of Sponsor:______
Tel. Home: ______Office: ______Mobile:______
Fax: ______E-Mail:______
Note: Deadline for receiving fully filled application form is 15/12/2014
2.0 EDUCATION BACKGROUND
2.1 Advanced Certificate of Secondary Education Examination (A.C.S.E.E.) Form Six or Equivalent
SUBJECT / GRADE / DATE / INDEX NoDivision/Class: ______Examining Authority: ______
Examination Centre or School: ______Country:______
2.2 Certificate of Secondary Education Examinations (C.S.E.E.)/National Form Four/or Equivalent.
SUBJECT / GRADE / DATE / INDEX NoDivision/Class: ______Examining Authority: ______
Examination Centre or School: ______Country:______
3.0 EMPLOYMENT RECORD
Please give details of your employment record in the table below
S/N / Name of Employer / Position Held / Dates (eg from-to-)4.0 ATTACHMENTS
Your application form MUST be submitted together with the following attachments:
- Certified Copies of Academic Certificates
- Certified Copy of Birth Certificate. Affidavit and Deed Polls ARE NOT ACCEPTED (unless published in the government gazette)
- One Passport Size Photograph firmly affixed to the application form.
- Original Receipt of Application Fee/Bank Pay-in-Slip/Postal Money Order. All these should indicate the name of the CANDIDATE and name of PROGRAMME applied for.
5.0 DECLARATION
I ______(your full name) do hereby confirm, to the best of my knowledge, that the information given in this form and the attachments are correct and complete.
I understand that submission of false documents/information is a criminal offence punishable in a Court of Law.
Place______Date______
Signature of Applicant
______
NOTE:
INCOMPLETE APPLICATION FORMS SHALL NOT BE PROCESSED
SUBMISION OF FALSE INFORMATION OR RECORDS SHALL LEAD TO CRIMINAL PROSECUTION
RESULT SLIPS WILL BE ACCEPTED ONLY FOR THOSE WHO COMPLETED THEIR STUDIES IN 2014 FOR FORM FOUR AND FORM SIX
DULLY FILLED FORMS SHOULD BE SUBMITTED TO THE COURSE COORDINATOR MAHINYA TRAINING CENTRE FOR SUSTAINABLE AGRICULTURE P.O. BOX 1282, SONGEA RUVUMA, TANZANIA
Deadline for receiving dully filled Application Forms is: 15/12/2014
MAHINYA TRAINING CENTRE FOR SUSTAINABLE AGRICULTURE
FEES STRUCTURES FOR THE ACADEMIC YEAR 2015/2017
YEAR 1 / YEAR2 / YEAR3TUITION FEE / 420.000 / 500.000 / 500.000
MEALS AND ACCOMODATION / 520.000 / 600.000 / 600.000
COUTION MONEY / 20.000 / 20.000 / 20.000
EXAMINATION FEES / 20.000 / 20.000 / 20.000
BOOKS AND STATIONARIES / 15.000 / 15.000 / 15.000
MEDICAL CAPITATION / 40.000 / 40.000 / 40.000
STUDENTS ORGANIZATION / 5.000 / 5.000 / 5.000
TOTAL DIRECT COST / 1.040.000 / 1.200.000 / 1.230.000
NOTE:
- The students will be registered after meet the payment of at least 60% of the total direct cost (i.e. 60% of Tshs 1.040.000 for the start of year 1 and the same to the total direct cost of the second year)
- The remaining 40% must be paid at the start of the second semester of the particular year.
- Caution money will be refunded at the end of the course if and only the student does not caused damage or loss of the centres properties
- Students who want to undergo field for level one course in animal husbandry, costs associated with such field will be paid by the student at his or her own cost. The centre may provide the student with the field request letter if required. Field attachment will be allowed during holidays.
- MEDICAL CAPITATION IS COMPULSORY FOR ALL STUDENTS and MUST BE PAID ON REGISTRATION AT THE CENTRE. If you are already a member of national health insurance fund (NHIF) or other security funds you will be required to pay Tshs 20,000/= only to the centre to cover for other expenses which are not covered by such security funds.
- Tuition fee paid for that particular academic year, and it is subjected to review from time to time when needs arises.
- All payment must be done through bank account Number 01J1093812800 ACC NAME COPE SAAFI and submit the bank payslip at the date of registration.