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The Catholic University of Zimbabwe

The document is an application form for undergraduate study at The Catholic University of Zimbabwe. It requests personal details of the applicant such as name, date of birth, citizenship, qualifications, references, and financial information. The applicant must provide certified copies of certificates and details of legal guardian, next of kin, employment history, and declarations confirming the accuracy of the information. If accepted, the university will provide an application number and note the receipt of supporting documents.

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108 views4 pages

The Catholic University of Zimbabwe

The document is an application form for undergraduate study at The Catholic University of Zimbabwe. It requests personal details of the applicant such as name, date of birth, citizenship, qualifications, references, and financial information. The applicant must provide certified copies of certificates and details of legal guardian, next of kin, employment history, and declarations confirming the accuracy of the information. If accepted, the university will provide an application number and note the receipt of supporting documents.

Uploaded by

LEM tv
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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OFFICIAL STAMP

THE CATHOLIC UNIVERSITY OF ZIMBABWE


Undergraduate Application Form
Please complete all sections of the form in BLOCK CAPITALS. Use BLACK or BLUE INK ONLY
Degree choice (tick one)
Bachelor of Business Management & Information Technology Honors
Bachelor of Arts Honors STUDY MODE (tick)
Bachelor of Theology
Block Release Program (including teachers) Full Time:
Bachelor of Accounting Honors Degree Part Time:
Bachelor of Business Management Honors Degree
Bachelor of Social Science Honors Degree Block:

SECTION 1: (APPLICANT DETAILS)

1.1 TITLE (MR/MRS): ……….

1.2 SURNAME (S): LL L A S T N A M E

1.3 FIRST NAME: B I R T H E N T R Y N A M E (S)

1.5 MARITAL STATUS: MARRIED SINGLE WIDOW DIVORCED

1.6 GENDER: MALE FEMALE (tick)

1.7 CITIZENSHIP:

1.8 NATIONAL I.D NUMBER: -

1.9 DATE OF BIRTH D D M M Y Y Y Y

1.10 COUNTRY OF BIRTH:

1.11 CITY / TOWN / AREA OF BIRTH

1.12 PHYSICAL ADDRESS:

+
1.12 PHONE:
1.13 E-MAIL: …………………………………………………………………………..
1.14 RELIGION & DENOMINATION: ________________________________________

1.15 HEALTH:
Do you suffer from any physical or other disabilities for which special arrangements would be required
at the University? If yes give details. Yes No (delete inapplicable)
__________________________________________________________________________________

www.cuz.ac.zw
2. LEGAL GUARDIAN DETAILS

(GUARDIAN)

2.1 NAME AND SURNAME:

CONTACT NUMBER(S) +

ADDRESS

RELATIONSHIP: ……. ………….. _____________ D D M M Y Y Y Y


(Legal Guardian) (Date signed)

3. NEXT OF KIN DETAILS

3.1 NAME AND ADDRESS:

+
3.2 PHONE:
………………………… D D M M Y Y Y Y
(Next of kin) (Date signed)

4. ACADEMIC QUALIFICATIONS
*(APPLICANTS MUST SUBMIT CERTIFIED COPIES OF ALL CERTIFICATES)

4.1 ‘O’ LEVEL


SECONDARY SCHOOL ATTENDED _______________________________________________

D D M M Y Y Y Y T O D D M M Y Y Y Y
SUBJECT EXAMINATION BOARD DATE OF EXAM GRADE/RESULT
DDMMYYYY
DDMMYYYY
DDMMYYYY
DDMMYYYY
DDMMYYYY
DDMMYYYY
DDMMYYYY
D D MM Y Y Y Y

2
4.2 “A” LEVEL QUALIFICATIONS
SECONDARY SCHOOL ATTENDED: __________________________________________

D D M M Y Y Y Y T O D D M M Y Y Y Y

SUBJECT EXAMINATION BOARD DATE OF EXAM GRADE/RESULT


DDMMYYYY
DDMMYYYY
DDMMYYYY
DDMMYYYY

4.3 OTHER POST ‘O’ LEVEL QUALIFICATIONS: EXAM LEVEL: ______________________


SUBJECT AWARDING BOARD DATE OF EXAM GRADE/RESULT
DDMMYYYY
DDMMYYYY
DDMMYYYY
DDMMYYYY

5. FINANCIAL SUPPORT
WILL YOU (OR YOUR GUARDIAN) BE ABLE TO PAY YOUR UNIVERSITY TUITION FEES? YES NO

IF YES NAME OF INDIVIDUAL RESPONSIBLE FOR PAYING TUITION FEES


______________________________________________________________________________________

PHONE: +

E-MAIL: …………………………………………………………

5.2 WILL YOU APPLY FOR A GOVERNMENT SUPPORTED LOAN? YES NO


IF YES NAME OF INDIVIDUAL WILLING TO BE A GUARANTOR
NAME: _________________________________________________________________________
PHONE: ________________________________________________________________________

5.3 OTHER SPONSORSHIP (PLEASE SPECIFY)_______________________________________________


_______________________________________________________________________________

6. EMPLOYMENT HISTORY (MOST RECENT POST ‘O’ LEVEL ONLY)


POSITION DATE(from) DATE(to)
NAME & ADDRESS OF EMPLOYER
HELD (DDMMYYYY) (DDMMYYYY)

3
REFERENCES

Give the Names of TWO (2) referees willing to provide you with a character references.

*Name: ___________________________________________ *name: ______________________________________


Address: ___________________________________________ Address: ______________________________________
*Phone: ___________________________________________ *phone: ______________________________________

8. DECLARATIONS
We confirm that information provided in this form is accurate to the best of our knowledge

SIGNED ____________________________ SIGNED ______________________________


APPLICANT LEGAL GUARDIAN

DATE ______________________________ DATE: ________________________________

FOR OFFICIAL USE ONLY

D D M M Y Y Y Y
DATE RECEIVED:
RECEIPT NO:

APPLICATION NO: ____________________

CERTIFICATES RECEIVED
YES NO

BIRTH CERTIFICATE
NATIONAL ID
“O” LEVEL
“A” LEVEL

MARITAL STATUS: _____________

ENTRY TYPE: ____________________

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