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Student-Application-Form

The document is a Student Application Form for Northern Technical College, requiring personal information such as name, nationality, contact details, and course choices. It also includes sections for educational background, examination results, previous institutions, sponsorship details, and disability status. The form is designed for prospective students to apply for admission into the college.

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bridgetkasapo83
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Download as PDF, TXT or read online on Scribd
6 views

Student-Application-Form

The document is a Student Application Form for Northern Technical College, requiring personal information such as name, nationality, contact details, and course choices. It also includes sections for educational background, examination results, previous institutions, sponsorship details, and disability status. The form is designed for prospective students to apply for admission into the college.

Uploaded by

bridgetkasapo83
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
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This Application Form may be photocopied

Northern Technical College

STUDENT APPLICATION FORM

1. Surname: …...……………………….………………………… 2. First names:……………………………………..…………………………


3. N.R.C. NO: …………………………..………………………….. 4. Nationality: ……………...………………………………..………………..
5. Date of Birth: ……..…………………………………………….. 6. Sex: ………….…………………...……………………………….………..
7. Residential Address:………….………………………………………………………………………………………………..…………………...
……………………………………………………………………………………………………………………………………………………...…
8. Tel/Cell No.: ……………………………………………………………. 9. E-Mail: ……..……………………………………………………….
10. Course: 1st Choice: …………..………………………………………………………………………………………………..………………….
2nd Choice: ……………….………………………………………………………………………………………………..…………….
11. Intake (Tick where applicable): May September January

12. Secondary School attended:……………….…………………………………………………………………….……,,,,,,,,,,,,,,,,,,………….…


13.. School Certificate Examination Results 14. Year of completion: …………………………………………….……………..

SUBJECT GRADE SUBJECT GRADE SUBJECT GRADE

i. Mathematics ……….. viii. Agric. Science ……….. xv. Commerce …….


ii. Physics ……….. ix. Biology ……….. xvi. Art …….
iii. Chemistry ……….. x. Geography …….… xvii Homecraft/Cookery …….
iv. Science ……….. xi. History ……….. xviii. French …….
v. English Language ……….. xii. Metal Work ……… xix. Zambian Language …….
vi. General Science ……….. xiii. Technical Drawing ………. xx. Religious Education …….
vii. Physical Science ……….. xiv. Principles of Accounts……. xxi. Other …….
15. Previous Institution(s) attended (if any):………………………..……………………………………………………………………………….
16. Dates attended: from:…………………………………………………… To: ……………………………………………………………………
17. Qualification obtained (attach copy):…………. ……………………………………………………………………….………………………..
18. Sponsorship: Available: (Tick where applicable) Yes No

If Yes, State: (a) Name of Sponsor/ Guandian ….….……………………………………………………………………………….............


(b) Tel/ Cell No.: ………………………………………………………………………………….…………………………….
19. Are you disabled? Yes/No. (If yes, specify nature of disability): …………………………………………………………………………….
20. Applicant’s Signature: …………………………………………….………… 21. Date: ……………………………………………………
22.. FOR OFFICIAL USE ONLY
Ref No. Payment Receipt No. Date paid Date Stamp
Cash Postal order

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