University of Namibia: E: Postgraduate Studies

E: POSTGRADUATE STUDIES
CHECKLIST FOR APPLICANTS: (Please mark enclosed) ID Document - cer ed copy or Passport - cer ed copy or Birth Cer cate - cer ed copy School Leaving Cer cate - cer ed copy Applica on Fee Ocial Transla on (Non-English Documents)
This applicaon is not binding on either the applicant or the University of Namibia. All informaon will be treated as condenal. An applicaon fee as specied below must accompany this applicaon.
UNIVERSITY OF NAMIBIA
ACADEMIC YEAR APPLIED FOR: PASSPORT PHOTO OF APPLICANT (Compulsory)
NQA Evalua on (Interna onal Qualica ons) Academic Transcript(s) Degree Cer cate(s)
The closing date for applica ons: 31 July No late applica ons will be accepted
Please a ach a recent passport photograph of yourself.
Instruc ons: Use block le ers to complete this form where space is provided or place an X in the correct square. Incomplete applica ons will not be accepted. All cer ed documents will be led - no copies will be returned to applicants.
Applica on Fees (Non-refundable) The following must be paid at the nearest Centre/Campus or into UNAM Bank Account. (Please a ach proof of payment to applica on form) Namibian Applicants (un l 31 July) Interna onal Applicants (un l 31 July) N$100 N$200
Completed applica on forms must be mailed to: The Oce of the Registrar, University of Namibia, Private Bag 13301, Windhoek, NAMIBIA.
For Ocial Use
STUDENT NUMBER:
SECTION 1: PROPOSED COURSE OF STUDY

Course of study for which you wish to enrol: First Choice: Second Choice: Campus Full-Time *Qualica on Code *Qualica on Code Part-Time
(Your second choice will be considered if your rst choice applica on is unsuccessful or not oered.) (* See insert for qualica on code)
SECTION 2: APPLICANTS PARTICULARS

Title: Surname: First Name in full: Ini als: Mr Ms Other (specify)
SECTION 3: CONTACT PARTICULARS

Postal Address: Residen al Address:
+ Code: Cell No: Fax No: E-mail:
FOR OFFICIAL USE ONLY: ACCEPT FIRST CHOICE CONDITIONS APPLICABLE: ACCEPT SECOND CHOICE RETURNED REJECTED
SECTION 4: PERSONAL PARTICULARS

Date of Birth: Passport No.: Gender: Mother Tongue: Ci zenship: Namibian Other (specify) M F
D D M M Y Y Y Y
I.D. No.: Marital Status: Maiden Name:

(if applicable)
Single
Married
Home Town: If not a Namibian ci zen, please apply for a study permit from your country of origin.
Do you have a disability? If yes please specify. Based on your disability, do you have special needs?
Yes
No
(for planning purposes only)
Yes
No
Do you suer from any nervous aec on or mental abnormality? Yes If yes please give details of the nature, severity, date and dura on of the illness.
No
Do you suer from any other illness?
Yes
No
If yes please give details of the nature, severity, date and dura on of the illness.
(Please note that you may be contacted.)
SECTION 5: EMPLOYMENT PARTICULARS (only if applicant is in full- me employment)

Name of Employer: Your Occupa on: Employers Postal Address: Employers Telephone No.:
SECTION 6: APPLICANTS NEXT OF KIN/LEGAL GUARDIAN PARTICULARS

(To be contacted in case of emergency.)
Family rela onship with the person whose par culars are supplied. Spouse/Partner Title: Surname: First Names in full: I.D. No.: Home Address (next of kin): Tel No.: Work Tel. No.: Home Employer (next of kin): Occupa on: Employers Address: Cell No.: Ini als Father Mr Mother Ms Brother/Sister Other (specify)
SECTION 7: FORMAL STATISTICAL INFORMATION

Region of Origin (if residing in Namibia) or country of permanent residence: Karas Hardap Khomas Erongo Omaheke Otjozondjupa Kunene Omusa Oshana Ohangwena Otjikoto Kavango Caprivi Other (specify)
SECTION 8: POST-SCHOOL ACADEMIC QUALIFICATIONS

Note: A full Academic Record issued by the instuon should accompany this applicaon.
Student No. Name of Programme (e.g. BA): Student No. Name of Programme (e.g. BA): Student No. Name of Programme (e.g. BA): Student No. Name of Programme (e.g. BA):
From Year
To Year
Name of University/Technikon/College Awarded: Y N
From Year
To Year
From Year
To Year
From Year
To Year
Name of University/Technikon/College Awarded: Y Y Y N N N
Have you ever been refused admission to any Ter ary Ins tu on? Are you currently enrolled at the University of Namibia? If yes please indicate course of study.
SECTION 9: ACHIEVEMENTS
A. GENERAL Posi on Field of Ac vity Number of Years
Indicate any leadership/managerial posi ons held:
DECLARATION
I hereby declare that all the par culars given in this applica on form are true and correct. I further declare that my enrolment as a student at the University of Namibia (UNAM) shall be subject to the terms and condi ons contained in the agreement, which I shall complete and sign at registra on.
SIGNATURE OF APPLICANT
Date
BANK DETAILS
UNIVERSITY OF NAMIBIA FIRST NATIONAL BANK - WINDHOEK Account number: 55500057621 Branch code: 281872 Swi code: FIRNNANX Fax number: +264 61 206 3704/3121
FOR OFFICIAL USE ONLY: APPLICATION FEE RECEIVED: _____________ LATE FEE RECEIVED: ____________________ RECEIPT NUMBER: _________________________ RECEIPT NUMBER: _________________________

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E: POSTGRADUATE STUDIES

Please a ach a recent passport photograph of yourself.

SECTION 1: PROPOSED COURSE OF STUDY

SECTION 2: APPLICANTS PARTICULARS

SECTION 3: CONTACT PARTICULARS

+ Code: Cell No: Fax No: E-mail:

SECTION 4: PERSONAL PARTICULARS

I.D. No.: Marital Status: Maiden Name:

(for planning purposes only)

(for planning purposes only)

Do you suer from any other illness?

(for planning purposes only)

SECTION 5: EMPLOYMENT PARTICULARS (only if applicant is in full- me employment)

SECTION 6: APPLICANTS NEXT OF KIN/LEGAL GUARDIAN PARTICULARS

SECTION 7: FORMAL STATISTICAL INFORMATION

SECTION 8: POST-SCHOOL ACADEMIC QUALIFICATIONS

Name of University/Technikon/College Awarded: Y N

Name of University/Technikon/College Awarded: Y N

Name of University/Technikon/College Awarded: Y N

Name of University/Technikon/College Awarded: Y Y Y N N N

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