application form b - ARCHBISHOP JAMES UNIVERSITY COLLEGE

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: saut.songea@yahoo.com 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: admission@ajuco.ac.tz
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: saut.songea@yahoo.com or admission@ajuco.ac.tz, 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