COUNCIL OF CHURCHES IN ZAMBIA

DAVID LIVINGSTONE COLLEGE OF EDUCATION

In association with

THE UNIVERSITY OF ZAMBIA

APPLICATION FORM NUMBER

(Official use only)

THE REGISTRAR, P/BAG 1, NAKATINDI ROAD, LIVINGSTONE,ZAMBIA

TEL:+260977505386/ +260955949494 FAX+260213 321987 EMAIL:

APPLICATION FOR ADMISSION (DEGREE PROGRAMME)

INSTRUCTIONS:

  1. Read through the instructions carefully before filling in this application form.
  2. Provide correct information where it is required.
  3. Attach all supporting certified documents (i.e. academic/professional qualifications and NRC)
  4. All applications must be addressed to the Registrar, DALICE
  5. Please write in block letters and or tick where appropriate.
  1. Attach a latest passport size photograph to your application form
  2. Closing date is 31st January 2017

MODE OF STUDY: PART TIME

DISTANCE

*Tick the method of study appropriate for you ______

FOR OFFICIAL USE ONLY

ACCEPTEDREJECTED

REGISTRAR’S COMMENT: ______

______

For more information contact the following 0977528293/0979308299/0977477246

PART A: PERSONAL DETAILS (Applicant completes this section in capital letters)

1 / Surname
2 / Other name (s)
3 / Sex / Male Female (Tick appropriately)
3 / Nationality
4 / Marital Status
5 / Date of Birth
Date / Month / Year
6 / Place of Birth
7 / NRC /
/

8 / Passport number (Non-Zambians)
8 / Details of registered physical challenges (specify disabilities if any)
9 / E-mail address (if any)
10 / Applicant’s mobile contact
11 / Postal Address
12 / Physical Address (Street/City/Town/Township)
13 / Province
14 / Name of Sponsor
15 / Relationship to Sponsor
16 / Contact Address of Sponsor (Postal not Physical)
17 / Sponsor’s mobile contact
18 / Denomination

PART B: EDUCATIONAL BACKGROUND (In capital letters)

19.School/s attended

SNO / SCHOOLS ATTENDED / GRADE LEVEL / YEAR
1
2
3

20. Professional Background

SNO / COLLEGES/ INSTITUTION / QUALIFICATION / YEAR OBTAINED
1
2
3

20.School Certificate Results in best five (5) subjects including English (Grades 1- 6 only)

SNO / SUBJECT / GRADE / YEAR OBTAINED
1
2
3
4
5

PART C: UNDERGRADUATE PROGRAMS (indicate your first (1) and second (2) choice)

21.Applicants wishing to train under this program should have a certificate or diploma in education or related field.

SNO / SUBJECT COMBINATIONS / CHOICE
1 / Bachelor of Education (English Language and Civic Education)
2 / Bachelor of Education (English Language and Geography)
3 / Bachelor of Education (English Language and History)
4 / Bachelor of Education (English Language and Religious Education)
5 / Bachelor of Education (English Language and Physical Education)
6 / Bachelor of Education (English Language and Linguistics & African Languages)
7 / Bachelor of Education (Mathematics and Civic Education)
8 / Bachelor of Education (Mathematics and Geography)
9 / Bachelor of Education (Mathematics and History)
10 / Bachelor of Education (Mathematics and Religious Education)
11 / Bachelor of Education (Mathematics and physical Education)
12 / Bachelor of Education (Mathematics and Linguistics & African Languages)
13 / Bachelor of Education (Physical Education and Civic Education)
14 / Bachelor of Education (Physical Education and Geography)
15 / Bachelor of Education (Physical Education and History)
16 / Bachelor of Education (Religious Education and Civic Education)
17 / Bachelor of Education (Religious Education and Geography)
18 / Bachelor of Education (Religious Education and History)
19 / Bachelor of Education (Linguistics & African Languages and civic Education)
20 / Bachelor of Education (Linguistics & African Languages and Geography)
21 / Bachelor of Education (Linguistics & African Languages and History)
22 / Bachelor of Education (Agricultural science Education)
23 / Bachelor of Education (Business Studies Education)
24 / Bachelor of Education (Early Childhood Education)

NOTE: All the above subject combinations go with education foundation courses.

22. OTHER PROGRAMS ON OFFER

These programs are designed for part time as well as distance study

S/NO / PROGRAM / TICK YOUR CHOICE
1 / Certificate in Teaching Methodology (1 Year)
2 / Certificate in French for Tourism Industry (1 Year)
3 / Certificate in Entrepreneurship Education (1 Year)
4 / Diploma ICT in Education (3 years)

23. APPLICANT’S DECLARATION

I, ………………………………………………………..hereby declare that all the details I have supplied on this application form are true and correct to the best of my knowledge. I further undertake to comply with the institution’s rules and regulations (code of conduct).

Applicant’s signature:…………………………………….. Date:……………………………………………………….

For official use ONLY!

Accepted:………………………

Not accepted:………………….

Reason for not being accepted:

……………………………......

………………………………………………………………………………………………………………………………………………………………………………………………

Registrar’s signature:………………………………………Date…………………………

NB:After completing filling in the form send it to the Registrar attaching a copy of the deposit slip of a non-refundable application fee of K120.00 made to the following account:

BANK NAME/BRANCH: FINANCE BANK – LIVINGSTONE BRANCH

ACCOUNT NAME: DALICE GPF ACCOUNT

ACCOUNT NUMBER:0234927740017

*Forms without a copy of the deposit slip attached will not be processed