PG1 FORMS
description
Transcript of PG1 FORMS
10/22/2009 PG1
University of Malawi
Chancellor College
P.O. Box 280, Zomba, MalawiTel: (265) 524222; Fax (265) 524046; E-mail: [email protected]
APPLICATION FOR REGISTRATION AS A POSTGRADUATE STUDENTTo be presented in triplicate and to be sent to the respective Department
A. PERSONAL1.Surname: ………………………………… 2. Forenames: ……………………………….
3.Sex: ……………………………………… 4. Date of birth: ……………………………..
5.Nationality: ………………………………. 6. Country of birth: ………………………….
7.Marital status: ……………………………. 8. Maiden name: …………………………….
(if married woman)9. Home address: ……………………………………………………………………………………..
……………………………………………………………………………………………………..10. Present postal address: …………………………………………………………………………….11. E-mail address:…………………………………………………………………………………….12. Next of kin: (a) Name ………………………………………………………………………..
(b) Address: …………………………………………………………………….
………………………………………………………………………………….
(c) Relationship …………………………………………………………………
B. TERTIARY EDUCATION13. First Degree: ………………………………13.Awarding Institution: …………………….
14.Date of award: …………………………….15.Class of award: …………………………...16. Other degrees or awards (give name of awarding institution/body and date):
……………………………………………………………………………………………………..
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(attach copies of transcripts and certificates of tertiary education qualifications)
17.Research experience: …………………………………………………………………………….
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C. DETAILS OF PROPOSED STUDY
18. Degree Sought: …………………………………………………………………………………..19. Proposed area/discipline of study (i.e. Biochemistry, Ethnobotany) ………………………20. Proposed topic of study: ………………………………………………………………………..21. Method of study (e.g. part-time or full-time) …………………………………………………
0/22/2009 PG1
D. REFEREES (candidate to solicit the references)22. Name and addresses of TWO Academic Referees:
(a) Name:…………………………………………………………………………………………….
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(b) Name:…………………………………………………………………………………………….
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Signature of Applicant ……………………………Date:……………………………….
E. FOR COLLEGE USE ONLY
23.Application presented by: Name: ………………………………………………………
Position:…………………………………………………….
24.Application considered by Post-graduate Committee on: ..………………………………...
25.Recommendation of Post-graduate Committee:……………………………………………..
……………………………………………………………………………………………………..
……………………………………………………………………………………………………..
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Signature of Chair of Post-graduate Committee:…………………………………………….