UDSM/PG.

F14
UNIVERSITY OF DAR ES SALAAM
Directorate of Postgraduate Studies
FREEZING OF STUDIES FORM*1
(This form should be filled in quadruplicate)
1. Personal Profile
Surname:....................................................First Name:................................... Middle Names:.........................
Sex ……............. Nationality: ..................................Mobile No:.....................................................................
Registration Number:.......................... Date and Year of Entry: .................. Expected Completion Date: ........................
Year of Study( e.g 1st, 2nd ): .............................. Semester: .................... Academic Year:................................
Programme: .......................................................................................................................................................
Department: ........................................................ Academic Unit: ....................................................................

2. Personal Contacts
Postal Address: …..........…….…………………..............….........................………...............………..….…..
Mobile Number: .......................……….........….. Other Telephone Numbers: ...…….….............……….…...
Email:………………..........…….………………….….........................………........................………..….…..
3. Reasons for Freezing Studies2: Please tick (√) the appropriate box
Medical /Financial /Social / Others

Briefly
Explain3: .........................................................................................................................................................................
...........................................................................................................................................................................
...........................................................................................................................................................................
...........................................................................................................................................................................
...........................................................................................................................................................................
4. Freezing Period Sought
Starting Date: ............................................... Expected Date of Resuming Studies: .......................................

5. Freezing History
1st Freezing: From: ................................................. To: .......................................................
2nd Freezing: From: ................................................ To: .......................................................
3rd Freezing: From: ................................................ To: .......................................................

6. You will be required to attach a copy of this form on resuming studies

DATE SUBMITTED: ............................................... SIGNATURE: ...................................................

1
This form is applicable to be filled in by candidates pursuing postgraduate programmes by Thesis or those candidates who have already completed the
coursework stage and have started undertaking the research part of their studies. No candidate can be allowed to freeze studies if the candidate has not paid
tuition fees and officially be registered for studies.
2
A candidate may attach any relevant documents to support his/her request. The current academic progress should also be attached.
3
If freezing is sought on MEDICAL GROUNDS, candidate MUST attach a medical report certified by the Medical Officer In charge of the University of Dar
es Salaam Health Centre.
1
For Official Use Only
AUTHORIZATION FOR FREEZING OF STUDIES
7. Comments by the Student Supervisor:
a) Recommended b) Not Recommended

Remarks (if
any): ...................................................................................................................................................................
.
.....................................................................................................................................................................
.........................................................................................................................................................................
Name: ........................................................ Signature: ............................................. Date: ........................

8. Comments by the Head of Department:

b) Recommended b) Not Recommended

Remarks (if
any): .............................................................................................................................................................
........
.....................................................................................................................................................................
.....................................................................................................................................................................
Name: ........................................................ Signature: ............................................. Date: ........................

9. Comments by the Principal/Dean/Director of the Academic Unit:

a) Recommended b) Not Recommended

Remarks (if
any): ..............................................................................................................................................................
.......
.....................................................................................................................................................................
.....................................................................................................................................................................
Name: ........................................................ Signature: ............................................. Date: ........................

10. Recommendation by the Director of Postgradaute Studies:

a) Recommended b) Not Recommended

Remarks (if
any): .............................................................................................................................................
.....................................................................................................................................................................
.....................................................................................................................................................................
Name:: ........................................................ Signature: ............................................. Date: .......................

11. Recommendation by the DVC-Academic:

a) Recommended b) Not Recommended

Remarks (if
any): ............................................................................................................................................................
........
.....................................................................................................................................................................
.....................................................................................................................................................................
Signature: ............................................. Date: ...........................

12. Approval by the Vice Chancellor:

b) Approved b) Not Approved

Remarks (if
any): ............................................................................................................................................................
.........
.....................................................................................................................................................................
.....................................................................................................................................................................

2
SIGNATURE: ............................................. DATE: ....................................