NATIONAL FILM AND TELEVISION INSTITUTE (NAFTI) Accra, Ghana. APPLICATION FORM FOR ADMISSION TO REGULAR DEGREE PROGRAMMES FOR ACADEMIC YEAR BEGINNING ______/_________/________ PRINT IN BLOCK LETTERS 1. Full name…………………………………………………………….. (Surname) ……………………………………………………………………………………………………………………………… (Other Names) 2. Current Mailing Address…………………………………………….. Attach Passport size Photograph here ……………………………………………………………………….. Home Telephone………………………………….Mobile…………………………………………………. Office Telephone………………………………….E-Mail…………………………………………………. 3. Date of Birth………………………………………Place of Birth…………………………………………. (Day Month Year) 4. Nationality…………………………….Gender (Male /Female)……………Marital Status………………….. 5. Name and Address of Guardian/Sponsor…………………………………………………………………… ………………………………………………………………………………………………………………. Telephone (Home)………………………..(Office)……………………….(Mobile)………………………. Fax…………………………………………..E-Mail……………………………………………………….. 6. Name and Address of Educational Institutions attended with Certificates obtained. No Name and Address Year From To Certificate Obtained Other Professional Courses: (iv) (v) 1 7. Pease tick the appropriate entry option: MATURE STUDENT WASSCE SSSCE GCE 8. Indicate WASSCE/SSSCE, GCE ‘O’ and ‘A’ Level grades abtained in each attempt in their respective columns. WASSCE / SSSCE Grades ‘O’ Level Grades ‘A’ Level Grades Subject 1st 2nd 3rd 1st 2nd 3rd 1st 2nd 3rd 9. Details of Experience in the Media. (e.g. Theatre, Film and Television) ……………………………………………………………………………………………………………........ …………………………………………………………………………………………………………………. …………………………………………………………………………………………………………………. …………………………………………………………………………………………………………………. 10. Other relevant skills including your leisure activities …………………………………………………………………………………………………………………. …………………………………………………………………………………………………………………. …………………………………………………………………………………………………………………. 2 11. PROGRAMME REFERENCE Please tick to indicate the Programme in which you would like to specialize: Film Directing Editing Television Production Art Direction Motion Picture Photography Animation Film Sound Production 12. STATEMENT OF INTENTION: Briefly indicate why you are applying for this programme and what you hope to achieve at the end of it. …………………………………………………………………………………………………………… …………………………………………………………………………………………………………… …………………………………………………………………………………………………………… ……………………………………………………………………………………………………………. ……………………………………………………………………………………………………………. ……………………………………………………………………………………………………………. …………………………………………………………………………………………………………….. 13. Supporting Materials: List below all Certificates (photocopies only), photographs, paintings, drawings, scripts, films or videos that you are sending with this application. 1………………………………………… 2…………………………………………. 3………………………………………… 4…………………………………………. 5………………………………………… 6…………………………………………. 7………………………………………… 8…………………………………………. 9………………………………………… 10………………………………………... 14. How do you intend to finance your studies at NAFTI?.............................................................................. • Attach a letter of Financial Support from your Sponsor. 3 15. Name three Referees (one of which may be Head of your school). No NAME ADDRESS OCCUPATION 1. 2. 3. 16. Language Proficiency (Proficiency in English is a requirement). Please state whether you have a fluent, average or limited knowledge. Language English Reading Writing Speaking FOR FOREIGN STUDENTS ONLY 17. State currency in which your fees will be paid (US. Dollars, French Francs, Euros, Pound Sterling) etc: ………………………………………………………………………… DECLARATION 18. I certify that the information given in this form and the accompanying materials are complete and accurate to the best of my knowledge. I understand that any misrepresentation will render my application null and void. I accept NAFTI’s right to reject applications at any stage without giving specific reasons and I understand that the decision of NAFTI to reject an application is final. ……………………………………… ……………………………………….. Date Signature of Applicant 19. FOR OFFICIAL USE ONLY Qualification Vetted by : Application Fee: Name Receipt No: Signature : Date : Date : : 4 5