Scribd Logo
Upload

Welcome to Scribd!

  • 346 views

    Taya Institute College - CLZ: 1. Full-Time

    Uploaded by

    Collins Jr Kashala
    The document appears to be an application form for Taya Institute College. It contains personal information about the applicant such as name, address, date of birth, marital status, education history, and contact details for references. It also requests information about the applicant's health, criminal history, financial situation and desired course of study. At the end, the applicant acknowledges the accuracy of the information and agrees to the college's rules if accepted.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd

    Taya Institute College - CLZ: 1. Full-Time

    Uploaded by

    Collins Jr Kashala
    346 views4 pages
    The document appears to be an application form for Taya Institute College. It contains personal information about the applicant such as name, address, date of birth, marital status, education history, and contact details for references. It also requests information about the applicant's health, criminal history, financial situation and desired course of study. At the end, the applicant acknowledges the accuracy of the information and agrees to the college's rules if accepted.

    Original Description:

    School registration form

    Original Title

    TAYA REGISTRATION

    Copyright

    © © All Rights Reserved

    Available Formats

    DOC, PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    The document appears to be an application form for Taya Institute College. It contains personal information about the applicant such as name, address, date of birth, marital status, education history, and contact details for references. It also requests information about the applicant's health, criminal history, financial situation and desired course of study. At the end, the applicant acknowledges the accuracy of the information and agrees to the college's rules if accepted.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    346 views4 pages

    Taya Institute College - CLZ: 1. Full-Time

    Uploaded by

    Collins Jr Kashala
    The document appears to be an application form for Taya Institute College. It contains personal information about the applicant such as name, address, date of birth, marital status, education history, and contact details for references. It also requests information about the applicant's health, criminal history, financial situation and desired course of study. At the end, the applicant acknowledges the accuracy of the information and agrees to the college's rules if accepted.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    of 4

    TAYA INSTITUTE COLLEGE -CLZ

    EDUCATION WITH A DIFFERENCE

    .Aka teens and youths ablaze

    Creativity and Innovation through Education is a pathway to a progressive sustainable society


    We Are Located on Plot NO. 10812 Twatasha Road, Chawama

    P.O BOX 52142 Chawama, Lusaka, Zambia


    Tel: +260966885291/0978237037
    Email: Changingliveszambia.simplesite.com
    Visit our facebook page: Changing lives zambia

    1. Course of your choice FULL-TIME


    1st choice: Marketing & Entrepreneurship. Full time or distance or part-time (E-Learning✅ )
    2nd.Full time or distance or part-time (tick)

    2. Personal and family information


    Name : COLLINS KASHALA
    Home Address : 14 GARDENIA ROAD, AVONDALE, LUSAKA.
    Telephone : 0977603038
    Date of birth : 20 March 1990 Age : 30. Sex : Male
    Place of birth : Chingola. Country of Citizenship : ZAMBIAN

    3. Marital status (tick)

    SINGLE Engaged
    ✅

    Widower Separated
    Married Divorced

    4. If married please Give


    Name ………………………………………………………………………………………………………….
    Spouse ………………………………………………………………………………………………………..
    Address ……………………………………………………………………………………………………….

    5. Financial information
    How do intend to financially support your studies (tick)
    Self ✅ . Parents …… organization ……

    6. MEDICAL INFORMATION
    How would you D escribe Your General Healthy?
    Good Fair Poor
    ✅

    7. (a) Do You Have any Physical Disability? Yes No

    ✅
    (b) If yes describe …………………………………………………………………………………………………
    …….
    8. Have you ever had any mental or psychological problem? No Yes No
    ❌
    9. Do you smoke? Yes No
    ✅
    Do you drink? Yes No
    .✅

    10.(A) have ever been in trouble with law or convicted crime? Yes No
    (b) If yes when and what happened ………………………………………………………… ✅ ………
    …………………………………………………………………….
    11. Education background
    Institution year certification
    Primary school Chibote private school 1996-2003 School certificate
    Junior sec school Chainda primary school 2004-2005 ………………………….
    Senior Secondary Chongwe High School 2006-2008 ……………………………
    College/ universities Nill…………… …………… ……………………………
    Describe why you want to do this course?
    Iam very passionate about marketing firstly, am blessed with a creativity and with a natural gift
    of good communication skills with people from all works of life.
    Fill in the table below

    School Year Grade


    chongwe secondary 2008 GCE
    school

    Address ………………………………………………………………………………………………….
    Relationship ………………………………………………………………………………………For how long have
    known each other ……………………………………………………
    2. Name: Kakwezhi Kashala
    Address: Waterfalls area, lusaka.
    Relationship :Daughter . Phone NO : 0977603038
    For how long have you known each other 8yrs…….

    Acknowledgement
    I . Collins Kashala Here by certify that the information on this application is true and correct
    on the best of my knowledge and believe. I further acknowledge my substantial agreement
    with TAYA INSTITUTE statement of education and agree to obey all rules and regulations
    accepted as a student.
    I understand that this application will be contracted for personal information interviews and
    the referees I have listed will be contacted.
    If accepted for the course I understand that I will be dismissed as a student at any
    description of college officials at my time other reasons where it is determined that
    participation is not wise as a student. Therefore I also accept the 80% bursary on tuition
    fees which has been given to me.
    With this application form I have paid k 100.00 as my application fee which I know is non-
    refundable
    Date 31/06/2020
    Signature:
    Attachment
    1. Grade 12 certificate copy (GCE)
    2. Photocopy of your National Registration Card.
    3. 1 latest passport size photos
    4. Id fee k100 ( DURING EXAMS)
    5. Lab coat fee k 150 ( PSYCHOSOCIAL COUNSELORS)
    6. Graduation compulsory (k400)
    7. Exam fee k200 termly

    You might also like