Affix 2 stamp size photos with names written at the back FOR OFFICIAL USE ONLY ARCHBISHOP JAMES UNIVERSITY COLLEGE (A Constituent College of St Augustine University of Tanzania) P.O Box 466,Songea , Tanzania Tel: 0255-025-2602862, Fax: 255-025 2602861 E-mail: [email protected] website: www.ajuco.ac.tz APPLICATION FORM FOR ADMISSION ACADEMIC YEAR 2015 /2016 ( Note: Please fill all details in block letters) 1.0 PERSONAL PARTICULARS 1.1 Surname: …………………………………………………………………..………… First Name: ………………………………… Middle Names: ………………….…………………… (Note: The names and initial entered in this form must be exactly the same as those appearing on your A.C.S.E.E.Form VI or other certificates to be used for admission. If there is no surname or middle name in your certificate please do not write ) 1.2 Sex: Male: Female: 1.3 Date of Birth: ……………...….……..…...…………………………. 1.4 Place of Birth: …………………………… 1.5 Citizenship:… ………………...…................................. 1.6 Religion: ………………………………… 1.7 Marital Status: …………..……………………………….. 1.8 Address: ………..……....………………………………………..……………….…………………………. 1.9 Telephone Number(s): ……………………..……………… E-mail: ……...…….……………………… 1.10 Profession: …………………………………………………………………………………………………. 1.11 Father’s name: ……………………………………………… Occupation: …………………………... 1.12 Mother’s Name: ……………………………………………… Occupation: …………………………. 1.13 Do you have any kind of disability? Yes: No: If yes, specify…………………………… ………………………………………………………………………………………………………………………….. (Note: This Information is required in order for the University to arrange appropriate means of assisting you once admitted. It will in no way affect the decision to admit you) 2.0 FOR EMERGENCIES: Person to be contacted 2.1 Full Name: ………………………………....……………………………………………………………. 2.2 Relationship: ………………………………....…………………………………………………………. 2.3 Address ………………………………....………………………………………………………………. 2.4 Telephone ………………………………….Fax: ……………………..E-mail ………………… 3.0 EDUCATION BACKGROUND AND EMPLOYMENT RECORD ALL.SEC.SCHOOLS ATTENDED LOCATION DATES FROM (MO/YR) TO (MO/YR) CERT.INDEX NO 3.1 University/College Education Have you attended this University/College or any other Institutions of Higher Learning before? Yes: No: If yes, provide details in the table below. S/N Institution Attended Status (Graduated/ If graduated give Discontinue qualification attained Date Obtained ed/Absconded) Total number of years of schooling ……………….years ……….months……………………….. 3.2 Employment Record Please give details of your employment record in the table below. S/N Name of Employer Post Held Dates 4.0 Programme Sought in Order of Preference (Select from the list attached) Order of Preference Faculty Programme Code Full Name of Programme 1st Choice 2nd Choice 3rd Choice 5.0 Language fluency: Language Spoken Fair Good Written Very good Fair Good Very good 6.0 Referees Names and addresses of two referees who know your ability as a student and can assess your competence in written and spoken English (a) Full Name: ….………………..……....………………………………………..……………….………. Address:….………………..……....………………………………………..……………….………….. (b) Full Name: ….………………..……....………………………………………..……………….………. Address:….………………..……....………………………………………..……………….…………… 7.0 Sponsorship The sponsor should indicate here that the candidate would receive financial support for years he or she will spend at St.Augustine University. Name of sponsor: …....………………………………………..……………….……………………………… Address: ….………………..……....………………………Tel …………………………………….. Business OR Activity ….………………..……....……………Fax/ E-mail………………………….. I …………………………………………………..confirm that my Organization will give full financial support to…………………………………………………………………During the period of his/her education at St.Augustine University if he/she is accepted. Date ……………………………….signed…………………………………………. Official stamp or seal Declaration I declare that all information given in this form is correct. Signature of Applicant: …………………....………. Date.………………………………………….……… 8.0 PAYMENTS. Your non-refundable application fee of Tshs 20,000/= or US $ 25 should be paid to St. Augustine University of Tanzania via Bank Account number: 0150085128519 CRDB SONGEA (No Cheques are accepted) 9.0 ATTACHEMENTS. Please include the following with this application: (a) A medical Doctor’s Certificate stating that you are fit to follow this course. (b) Two (2) passport size photos of yourself (Colored). (c) A short history of your life in English (500-750 words or two fullscap) in your own handwriting, describing the important details of your life, your reasons for pursuing this courses of studies, and your plans for the future. (d) Photocopies of your school certificates OR results slip (Form IV and Form VI). (e) Birth certificate (f) Original pay slip of Tshs 20,000/= (for Tanzanian) or $ 25 (for Foreigner) When you have attached all required materials and have included certification of sponsorship (below) kindly send this to the office of the: (Please do not send by fax/E-mail) Admissions Office, St. Augustine University of Tanzania, P.O Box 466 Songea, Tanzania, Email: [email protected] ARCHBISHOP JAMES UNIVERSITY COLLEGE (A Constituent College of St Augustine University of Tanzania) P.O Box 466, Songea, Tanzania Tel: 0255-025-2602862, Fax: 255-025 2602861 E-mail: [email protected] or [email protected], tWebsite : www.ajuco.ac.tz PROGRAMMES OFFERED ACADEMIC YEAR 2015 /2016 FACULTY OF ARTS AND SOCIAL SCIENCES Programme Code Duration BASO Programme Name Bachelor of Arts in Sociology BBA Bachelor of Business Administration 3 Years BAMC Bachelor of Arts in Mass Communication 3 Years LLB Bachelor of Law 3 Years CLL Certificate in Laws 1 Year CICT Certificate in Information and Communication Technology 1 Year CBA Certificate in Business Administration 1 Year CLB Certificate in Library and Information Studies 1 Year Certificate in Journalism 1 Year Certificate in Accountancy 1Year Certificate in Procurement 1Year Basic Journalism Course 3 Month DICT Diploma in Information and Communication Technology 2 Years DBA Diploma in Business Administration 2 Years DLL Diploma in Laws 2 Years CA 3 Years DLB Diploma in Library and Information Studies 2 Years Diploma in Accountancy 2 Years Diploma in Procurement 2 Years FACULTY OF EDUCATION Programme Code Programme Name Duration BAED Bachelor of Arts with Education 3 Years FACULTY OF MEDICINE Programme Code Programme Name Duration MD Doctor of Medicine (Bachelor 4 Years
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