Scribd
Upload
8 views

Application Form

The document is an application form for graduate studies programs at Wachemo University, requiring personal data, academic and employment records, and fellowship information. Applicants must certify the accuracy of their information and submit various supporting documents. The form also includes a checklist of required documents and a reminder to check the academic calendar for entrance examination dates.

Uploaded by

aytbz2024
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
8 views

Application Form

The document is an application form for graduate studies programs at Wachemo University, requiring personal data, academic and employment records, and fellowship information. Applicants must certify the accuracy of their information and submit various supporting documents. The form also includes a checklist of required documents and a reminder to check the academic calendar for entrance examination dates.

Uploaded by

aytbz2024
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 3

Application Form

Wachemo University Office of the Registrar


Graduate studies programs Application form
Form No………………

FOR OFFICE USE ONLY


File No……………………. Fellowship/ Source of fund………………………………................
Specialization…………….. B.Sc/B.A/MSc/MA/MPH/MBA/MD+ Specialty or equivalent
degree...............................................................................................................................................

(To be filled out by the candidate) Please complete and send this form to:
Office of the Registrar
Wachemo University
P.O/.Box 667
E-mail………….......................
Tel. No………………………….
Fax……………………………
Hossa`ina, Ethiopia.
Personal Data (Please write in block letters)
Full Name…………………………………………………………………………………
Place and date of birth……………………………………………………………………
Sex……………Marital status…………………….Nationality……….…………………
Postal address……………………………………………………………….……………
City………………………………………..Country……………………………………..
Tel. No……………………………………..Cell phone……………………….……........
Fax………………………………………... E-mail ………………………….………….
FELLOWSHIP (Please mark in the boxes)
I will pay all my expenses (including research grant and tuition fee)
Fellowship is requested but has not yet been granted
Fellowship support is required
Fellowship has already been awarded

1
If the fellowship has been awarded, please indicate the name of the sponsor and attach
statement of award:
…………………………………………………………………......................................
....………………………………………………………………………………………………
…………………………………………………………………………………………………
……………………………………………………………………………................................
Please mark one: MSc/MA/MBA/MPH/PhD program and specialization
Program (Example: Animal and Range Science)

Specialization

Example : MSc in Animal production

Academic records (start from recently obtained credentials)

University/college country Major field Diploma/degr Year of attendance


of study ee/masters From To

Employment Records (Start from the recent employer)


Name of Address Position(s) held Service year
employer/Organi From To
zation

2
Publications (if any)

Attach list of articles you have published, write the name of journal(s) and year of publication
…………………………………………………………………………………………………
…………………………………………………………………………………………………
……………………………………………………………………….......................................
Checklist of documents submitted (mark in the boxes)
Completed application form
Copy of Diploma/Degree/Masters
Copy of transcript (student copy)
Curriculum vitae
Sponsorship letter (if any)
Recommendation letters (3)

Statement by the applicant

I hereby certify that all the information given in this form is complete and correct. I fully
realize that the university is entitled to take any action on me; including dismissal if the
information given by me here is found incorrect or misleading at any time. I also realize that I
will not be entitled to any reimbursement of whatever fee I might have paid in cases where
the university takes any action on me as a result of the incorrect or misleading information
given by me. I further undertake to observe all the rules and regulations of the university if I
am accepted by the university, and to refrain from any activity which may be contrary to the
interest of Ethiopian people. I shall take full responsibility for reading and abide by the rules
and regulations of the University.

Date and place:…………………Signature: ………………………..........................................

ATTENTION! Please check the academic calendar of Wachemo University for the date of
entrance examination

You might also like