2019 Chalimbana University Admission Form

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Chalimbana University Application Form
Chalimbana University
APPLICATION FOR ADMISSION
Email: chau.univ@gmail.com, registrar@chau.edu.zm Phone: 0977 485465
NAME OF APPLICANT: …………………………………………………………………………………
FOR OFFICIAL USE ONLY
Serial No: ……………… Date Received: ……………….. RECEIPT No. ……………………
PROVISIONALLY ACCEPTED
NOT ACCEPTED
Intake applying for (Tick):
(SEPTEMBER DISTANCE) SEPTEMBER (FULL-TIME)
Indicate the Programme /school for which you wish to be enrolled. (Please clearly tick or circle the number of
only one option)
DIRECTORATE OF RESEARCH AND GRADUATE STUDIES
1. Master of Education in Leadership and Management (Distance Only)
SCHOOL OF BUSINESS AND ENTREPRENEURSHIP (Distance and Full-time)
1. Bachelor of Business Administration with Education
2. Bachelor of Business Administration in Marketing
3. Bachelor of Business Administration in Entrepreneurship
4. Bachelor of Business Administration in Human Resource Management
5. Bachelor of Business Administration in Accounting and Finance
SCHOOL OF PHYSICAL EDUCATION AND SPORTS (Distance and Full-time)
1. Bachelor of Physical Education and Sports
2. Bachelor of Sports Management
SCHOOL OF LEADERSHIP AND MANAGEMENT (Distance and Full-time)
1. Bachelor of Education in Leadership and Management
SCHOOL OF EARLY CHILDHOOD STUDIES (Distance and Full-time)
1. Bachelor of Early Childhood Education
2. Bachelor of Science in Child Care and Development
3. Bachelor of Science in Child and Youth Studies
SCHOOL OF VOCATIONAL AND PRACTICAL SKILLS EDUCATION (Distance and Full-time)
1. Bachelor of Hospitality Management and Tourism
2. Bachelor of Design and Technology with Education (Secondary)
3. Bachelor of Home Economics with Education (Secondary)
4. Bachelor of Food Science and Nutrition
SCHOOL OF EDUCATION (Distance and Full-time)
1. Bachelor of Education -Secondary
2. Bachelor of Education-Primary
3. Bachelor of Guidance and Counselling with Education
4. Bachelor of Community Education and Development
5. Bachelor of Information and Communication Technology with Education
6. Diploma in Teaching Methodology (Distance Only)
Application Form
Chalimbana University Page 2 of 3
SCHOOL OF SCIENCE AND MATHEMATICS EDUCATION (Distance and Full-time)
1. Bachelor of Science with Education
2. Bachelor of Agriculture Science with Education
3. Diploma in Laboratory Technician
SCHOOL OF HUMANITIES AND SOCIAL SCIENCES (Distance and Full-time)
1. Bachelor of Arts in Gender Studies
2. Bachelor of Arts in Psychology
SCHOOL OF MUSIC, PERFORMING AND FINE ARTS (Distance and Full-time)
1. Bachelor of Arts in Music
2. Bachelor of Arts in Fine Arts
3. Bachelor of Arts in Applied Theatre
Instruction: Please use capital letters and tick where appropriate
PERSONAL DETAILS
Name: Cell:
Date of Birth: dd mm yyyy Sex: F M
Marital Status: Single Married Divorced Widow Widowed
(Tick one)
District: Province:
Address:
NEXT OF KIN
Name: ______________________________ Phone No. ______________________
Address: _________________________________________________________________
Relationship: ______________________________________________________________
ACADEMIC QUALIFICATION: SCHOOL CERTIFICATE OR GCE RESULTS
Enter your results below starting with English (5-Olevels)
S/N SUBJECTS GRADE YEAR OBTAINED
1
2
3
4
5
PROFESSIONAL QUALIFICATION
Write the Professional Qualification(s) if you have ANY and where obtained
QUALIFICATION WHERE OBTAINED PERIOD
Application Form
Chalimbana University Page 3 of 3
SUBJECT COMBINATIONS FOR SECONDARY DEGREE ONLY
Choose only one subject from category A for Major and one from B for Minor in the same row.
Category A Category B
BIOLOGY/MATHS/ICT CHEMISTRY/PHYSICS/BIOLOGY/ICT/MATHS
MATHS/ICT ICT/MATHS
ENG, MATHS, Z/L Z/L, R.E, CIVIC EDUC, HIST, ENG, GEO
MUSIC, ART & DESIGN. P.E R.E, CIVIC EDU, HIST, GEOG, MATHS, ENG
CIVIC EDUC, HIST, R.E, GEO R.E./GEOG/HISTORY/CIVIC EDU/ENGLISH ,
PE, MUSIC, ART & DESIGN
FOOD SCIENCE and NUTRITION (Single
major)
AGRIC SCIENCE (Single major)
DESIGN and TECHNOLOGY(single major)
BUSINESS STUDIES (Single major)
TEACHING METHODOLOGY
Subject Combination Chosen (Write down)
CATEGORY A(MAJOR) CATEGORY B( MINOR)
SPONSOR (Tick)
Self: Employer:
APPLICATION PROCEDURE
Send the filled in application form together with the certified copies of the NRC, academic and
professional qualifications and the original deposit slip of K150 bearing your full names to:
The Registrar, Chalimbana University, Private Bag E 1, Lusaka.
Bank details for depositing the application fee of K150.00;
Account Name: Chalimbana University
Bank: Atlasmara (Finance) Bank
Branch: Chongwe
Account Number: 0385 8151 3601 3
DECLARATION
I your name here in full____do declare that my personal information submitted is correct and that
my names appear in the same order as on my NRC. I fully understand that should this
information that I have given to the institution turn out to be false, my candidature will be
withdrawn.
Signature:
date:

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