Makerere Pre Entry LAW 2023 24

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MAKERERE UNIVERSITY

Tel : +256-414-533332/533258
P.O. Box 7062 Kampala Uganda
Cables : "MAKUNIKA" Fax: +256-414-4534125/4541771
Website: www.makerere.ac.ug E-mail : [email protected]

OFFICE OF THE ACAD E MIC REGISTRAR

UNIVERSITY BACHELOR OF LAWS PRE-ENTRY EXAMINATIONS


APPLICATION FORM FOR ACADEMIC YEAR 2023/2024.--------,

Three Passport Size


Photographs
RIGHT HAND
THUMB
PRINT

Note: This form must be submitted with evidence of payment of the Application fee

PARTl
To be completed in CAPITALS by the Applicant.

ALL NAMES MUST BE WRITTEN IN FULL AS INDICATED ON '0' LEVEL OR ANY OTHER ACADEMIC
DOCUMENTS
1. (a) Surname (in full) .. .. ..... ... .... ... ... ..... ....... ..... ............. ..... ......... .. .. ... .... .... . .

(b) 'A' Level Index No ... .... ..... .. ...... ........ ... ......... Year of 'A' Level Examination .. ........ .. ....... ... .

(c) Other names (in full), no Initials ......... .. ............ ...... ... .... .. .............. ..... ........ ....... ...... .. ...... ...
(d) Gender: (Tick), Male D Female D

(e) Date of Birth (DD .......... MM ........... YY ..... .. .... ) (e) Citizenship ....... .... ........... ...... .. ..... ....... .. .
(You must attach a copy of the Birth Certificate)

(f) Home District... ................................. ..

2. Uganda Certificate of Education (UCE) or its equivalent Index No .... ..... ...... .... .. .. .... ........ ........... ... ..
Year of Examination ........ .. ... ..... .. .. ......... ........ .... ............ .

SUMMARY OF GRADES
I DISTINCITONS I CREDITS I PASSES
You must attach a photocopy of the Uganda Certificate of Education(UCE) or its equivalent.

3. Uganda Advanced Certificate of Education(UACE) or its equivalent. Index No . ...................... ..

Year of Examination ............ .... ...... .. ....... ..... ... ' A' Level Points ................................................ .

Attach a photocopy of the UACE Certificate or its equivalent (Strictly a photocopy of the
Certificate or Result Slip must be attached where applicable.)

4. Sch 00 Is Atten de d., 1'f any


Year Name of Institution Qualification
From To obtained

In future correspondence please quote the reference number above


5. DIPLOMA/DEGREE HOLDERS/MATURE AGE (Tick where applicable)
Inst"ttuttons Atten de.,
d 1"f any
Year Name of Qualification Class of Award
From To Institution obtained (if any)

Attach the certified coptes of the Transcnpt and Certificates

PART II
6. Other Personal Information

(a) Marital Status (married, single, other. Please specify) ... ..... .. ... ..... ........ ....... ..... .... .... .... .. ..... .... ..

(b) Permanent Address ... ..... .... .......... ...... ... ... ...... ........ .. ....... .... ..... .... ... ... ....... ... .... ... .. .. ......... ...... .. .

(c) Emergency contact Address, if different from (b) above .... .......... .. .............. .. .... .. .. .... .. ........ .. .

(d) Telephone No .......... .. .... .. .. .... .... .. (e) Fax No. (If applicable) .... .... .. ...... .. ........ .. .. .. ....... ..

(f) E-Mail .... ... .. ... .. .. ....... .... .......... ...... ... .. ..... .... ... .......... .... ... .. .... .. .. ..... .. .... ... ..... ........... ........ ..... ...... .

(g) Religious affiliation (if any) ........ ...... ...... ........ ................. .... .... .. .......... .. .... .. .... .... .... .. ........ ...... ..

7. Information about Parents/Guardian (where applicable)

(a) Parent's/Guardian's name .. .. ...... .. .. ...... .. ................. .. (c) Guardian's occupation .. .. .............. .. .. ..

(b) Parent's/Guardian's address.......... .. .... .... .. .............. .. ... (d) Tel. Number .............. .. .............. .. .. ... .

8. Give 2 names of persons in responsible positions from whom confidential information about you may
be obtained if necessary.

'1) Name .... ... .. ...... .... .... ..... .... ....... ........... ........ ...... ...... ...... .... ... ...... .. .... .....

Address .... ... ........ .. ... ..... .... ...... ............ ............ ...... .. ..... .. ... ... ....... ..... .... .

E-mail: ........ ... ......... ... .. .. ... ...... .... .... ........... ...... .... ... ............ .. ... ....... .... .

Telephone Number .... ... ..... ..... ........ ......... .. ... ...... ....... ... ..... .... ... ......... .

ii) Name .. ..... ... ............... .. ... .. ..... ... ...... ..... .. .. ....... ........ ... ... .. .. .... .. .... .... .. .

Address .. ... ...... ..... .... .. .. .... ... .. ... ........... ........ ... ... ........... ... .... ... .... .. ......

E-mail : ..... ..... .. ....... ......... ................. .. ..... ... .... .. .... ... ..... ... ..... .. ... ..... ... .

Telephone Number: ...... .... ...... .... ... ..... ... .......... ...... .... ... ...... .. ... .. ... .... ..

9. It should be NOTED by all applicants that cases of impersonation, falsification of Documents or


giving false/incomplete informat ion whenever discovered, either at Registration or afterwa rds,
will lead to automatic CANCELLATION of Admission and prosecution in the Uganda Courts of Law.

10. Declaration by the appl icant:


I have noted and understood the implication of giving incomplete/incorrect information.
I confirm that the information given on this form, to the best of my knowledge, is correct.

Signature of the Applicant .... .... ...... ... ........ .. .. .. .. ........ .. . Date ........ ........... ...
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