APPLICATION FORM

UNDER GRADUATE APPLICATION FORM

All fields marked as * are required

SURNAME *

OTHER NAMES *

CITIZENSHIP / COUNTRY OF ORIGIN *

DATE OF BIRTH *

MARITAL STATUS *

SINGLE
MARRIED

FIRSTNAME *

GENDER *

MALE
FEMALE

PASSPORT or ID NO (indicate which) *

TOWN / PLACE OF BIRTH *

RELIGIOUS AFFILIATION

FOR RELIGIOUS

PRIEST
DEACON
SISTER
BROTHER

DIOCESE

CONGREGATION

PERMANENT ADDRESS

EMAIL ADDRESS *

PHONE NUMBER

NEXT OF KIN ADDRESS

NEXT OF KIN EMAIL ADDRESS *

NEXT OF KIN PHONE NUMBER

HAVE YOU EVER STUDIED AT TANGAZA UNIVERSITY COLLEGE BEFORE?

If yes, Previous Student ID Number

School of Institute

Year of Enrollment (FROM)

Year of Enrollment (TO)

UNIVERSITIES / COLLEGES ATTENDED (List and attach supporting documents)

Enter Institution, Duration, Programme/Award and Mark/Grade/GPA/Honours

HIGH / SECONDARY SCHOOLS ATTENDED (List and attach supporting documents)

Enter Institution, Duration, Programme/Award and Mark/Grade/GPA/Honours

NAME

Recommending Authority

ADDRESS

Recommendation and Sponsorship

FAX

Recommendation and Sponsorship

Congregation / Diocese / Organization

Recommendation and Sponsorship

TELEPHONE NUMBER

Recommendation and Sponsorship

INDICATE HOW THE FEE WILL BE PAID

NAME

Sponsor

ADDRESS

Sponsor

FAX

Sponsor

SELF/CONGREGATION/DIOCESE/ORGANIZATION

Sponsor

TELEPHONE

Sponsor

Sponsoring community, province or house if the congregation has more than one community, house or province sponsoring students in the College (Otherwise leave blank):

COMMUNITY/PROVINCE/HOUSE