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SILASI UNIVERSITY

REGISTRAR’S OFFICE

e-mail: website:

e-learning: face book: facebook.com/silasi university

P.O Box RW 50466, Lusaka. TPIN: 1004282596. Cell Phones +260 78215716, +260954302627

APPLICATION FOR ADMISSION – BACHELOR’S DEGREE

Official Use only

Receipt No:
Application No:

INSTRUCTIONS

Please read through the form carefully and fill in all the required information in capital letters. Attach certified copies of: National Registration Card and Grade 12 ‘O’ Level School certificate.

A non-refundable fee of K150 should be deposited in Silasi University Account No. 5591802500254 ZANACO, Cairo Road Business Center, Lusaka. Completed forms must be submitted to the offices or sent by email to registrar; .

PROGRAMME APPLIED FOR:

First Choice...... (Refer to Appendix one)

SecondChoice......

Commencement Date of academic year (January/June) ……………………………………......

Mode of study
Open Distance Learning
Category of Applicant (Tick)
School Leaver
Non School Leaver
Personal Data

Title: (Mr/Mrs/Ms/Dr/Prof): ______

Surname: ------

Other Names: ______

Gender: Male Female Date of Birth:

Marital Status: Married Single

Nationality: ______

National Registration Card No.: ______

If Non-Zambian, Passport No.: ______

Contact Details

Telephone No: ...... Mobile Phone No: ......

Email Address: ...... Fax: ......

Postal Address

______

______

Residential Address

______

Next of Kin:

Name ______

Telephone______

Address ------

Academic Background / Attached certified copy or results
Previous secondary school attended / From / To / Qualification
1.
2.
Five Subjects passedat ’O’ Level including English Language / Grade

Do you have any permanent injury, illness or disability which may affect your study?

Yes No

If yes, please describe the nature of your injury, illness or disability and measures to put in place

------

------

------

DECLARATION

I certify that the information given in this application and supporting documents is accurate and complete.

I understand that SILASI reserves the right to reverse any offer of admission made on the basis of inaccurate information.

Signature: ...... Date: ......

APPENDIX ONE

PROGRAMMES ON OFFER FOR THE 2018 ACADEMIC YEAR

SCHOOL OF EDUCATION

1.Bachelor of Arts with Education

Choose from the following teaching subjects combinations:

Civic Education with Religious Education

Civic Education with History

Civic Education with English Language and Literature

Civic Education with Linguistics and African Languages

2.Bachelor of Education in Guidance and Counselling with a teaching subject

Choose one of the following teaching subjects:

Civic Education

Religious Education

History

English Language and Literature

Linguistics and African Languages

3.Bachelor of Education in Special Education (Speech and Language Disorder) with a teaching subject

Choose one of the following teaching subjects:

Civic Education

Religious Education

History

English Language and Literature

Linguistics and African Languages

4. Bachelor of Education in Special Education (Sign Language) with a teaching subject

Choose one of the following teaching subjects:

Civic Education

Religious Education

History

English Language and Literature

Linguistics and African Languages

5.Bachelor of Education in Special Education (Braille) with a teaching subject

Choose one of the following teaching subjects:

Civic Education

Religious Education

History

English Language and Literature

Linguistics and African Languages

6. Bachelor of Education in Special Education (Intellectual Disability) with a teaching subject

Choose one of the following teaching subjects:

Civic Education

Religious Education

History

English Language and Literature

Linguistics and African Languages

MOTTO: MY GOD IS ABLE

1 | SILASI