Application For Admission - (Undergraduate) ACADEMIC YEAR 2012/2013 1246512

Rduit, Mauritius TELEPHONE:(230) 403-7400 FAX:(230) 454-9642/464-8004 Website: http://www.uom.ac.
mu
UNIVERSITY OF MAURITIUS
Established 1965
APPLICATION FOR ADMISSION(UNDERGRADUATE)

Entry Date Time:
20-Mar-2012 11:33 am
ACADEMIC YEAR 2012/2013 1246512

Application No.
1.
Surname(in full): Other Names(in full):
SEEBORUTH SANJIV
Maiden name (For married Women): 2. Address for correspondence:
Telephone No.
Home: Mobile: Office:
2955036 9176290
20, ROUTE ROYALE, LA-LOUISE, QUATRE-BORNES
Fax No. : Email: 3. Date of Birth 4. Sex 5. Marital Status
[email protected]
6. Nationality National ID No.
28-May-1991
Male
Single
Mauritian
S2805913021891
7.
Any Disability (Physical or otherwise) you would wish to apprise the University of:
8. TITLE OF PROGRAMME/S APPLIED FOR (IN ORDER OF PRIORITY) IMPORTANT NOTE : ONCE A CANDIDATE HAS BEEN OFFERED A SEAT ON AS A HIGHER PRIORITY NO OFFER WILL BE MADE ON AS LOWER PRIORITY A PROGRAMME INDICATED PROGRAMME/S INDICATED
Priority
Programme Name (As advertised)
Programme Code
1 2 3 4
BSc (Hons) Mathematics BSc (Hons) Mathematics with Computer Science BSc (Hons) Computer Science (Full-Time) BSc (Hons) Information Systems
SC320 SCE321 E318 E311
THE UNIVERSITY WILL NOT ACCEPT ANY CHANGE IN THE CHOICE AND ORDER OF PRIORITY OF PROGRAMMES AFTER AN APPLICATION HAS BEEN SUBMITTED.
20-March-2012
Page 1 of 6
YOUR APPLICATION WILL NOT BE CONSIDERED VALID AND AN OFFER OF A SEAT WILL BE AUTOMATICALLY WITHDRAWN IF INCORRECT INFORMATION IS GIVEN IN SECTIONS 9.1, 9.2, 9.3, 9.4, 10 and 11. 9. List all subjects already taken in exactly the same order as presented in your certificates. Give the three best attempts in sections 9.1 - 9.2.2 and the respective month/year of examinations. Group together all subjects taken at each sitting.
9.1
SC/GCE/IGCSE ORDINARY LEVEL RESULTS 1st Attempt SUBJECTS Index No.: MU127/0111 Date of Attempt (Month/Year):
11/07
GRADES (e.g. 1,2,3 or A,B,C)
ENGLISH LANGUAGE FRENCH MATHEMATICS ADDITIONAL MATHS PHYSICS CDT:DESIGN & COMMUNICATION COMPUTING
SC Grade Aggregate: 2nd Attempt SUBJECTS Index No.: MU191/0108
8 5 5 7 7 3 8
35 Date of Attempt (Month/Year):
11/08
GRADES (e.g. 1,2,3 or A,B,C)
ENGLISH LANGUAGE FRENCH MATHEMATICS ADDITIONAL MATHS PHYSICS CDT:DESIGN & COMMUNICATION COMPUTING
SC Grade Aggregate:
7 7 3 5 5 2 7
29
9.2
HSC ADVANCED LEVEL RESULTS (ENTER GRADES OBTAINED AT ADVANCED LEVEL ONLY - NOT ADVANCED
SUBSIDIARY)
Examining Body:
If other ,Specify:
Cambridge/London
1st Attempt
Index No.:
MU295/0590
Date of Attempt (Month/Year):
11/11
Subjects obtained at Principal or Advanced Level
GRADES should be exactly as per certificate i.e (A,BE for HSC ) & (1,27 for International BAC)
DESIGN & TECHNOLOGY MATHEMATICS PHYSICS
B C E
20-March-2012
Page 2 of 6
9.3
HSC SUBSIDIARY LEVEL RESULTS (ENTER GRADES OBTAINED AT SUBSIDIARY LEVEL ONLY) Examining Body:
If other ,Specify:
Cambridge/London
1st Attempt
Index No.:
MU295/0590
Date of Attempt (Month/Year):
11/11
Subjects obtained at Subsidiary Level
GRADES should be exactly as per certificate i.e (a,be for HSC ) & (1,27 for International BAC)
GENERAL PAPER FRENCH
c b
You are requested to verify your SC and HSC results carefully. Ensure that you have entered the subjects obtained at Advanced level in section 9.2 and those obtained at Subsidiary level in section 9.3. Any mistake on your part may result in your scores being wrongly computed 9.4 Rank at November/December 2011 HSC Examinations (if applicable):
10. PREVIOUS OR CURRENT PROGRAMMES FOLLOWED AT UNIVERSITY OF MAURITIUS.

Are you still a student at the University of Mauritius Has your registration been terminated on the basis of failure
Have you withdrawn from any programme
Student ID
Title of Programme
Ongoing/Withdrawn/ Failed
From
Month Year
To
Month Year
10.2 Give relevant information for programmes successfully completed at the University of Mauritius
Title of Programme Student ID
Degree/Diploma classification
Overall %/CPA/CPA
From Month Year
To Month Year
11.OTHER QUALIFICATIONS (Any other Post-Secondary Qualifications obtained)

Awarding Body Title of Award Level Achieved Percentage Achieved From Month Year To Month Year
12. THIS SECTION SHOULD BE FILLED IN BY THOSE IN EMPLOYMENT
20-March-2012
Page 3 of 6
Give all relevant information about previous and present employment as follows:
From
Month Year Month
To
Year
Name & Address of Employer /Firm
Position Held
Job Description
13. THIS SECTION IS RELEVANT TO NEEDY APPLICANTS ONLY
If you are in receipt of social aid from the Ministry of Social Security and National Solidarity, tick the box below and attach documentary evidence from the Ministry.
Tick the Box:
14. THIS SECTION IS APPLICABLE TO MATURE CANDIDATES ONLY (25 Years and above with at least 5 years of relevant work experience)
If you wish to be considered as Mature Candidate, it is compulsory for you to tick the box below and attach documentary evidence with regard to work experience. (Only those who have filled in this section and submitted the requested documents will be considered for admission as Mature Candidates.)
Tick the Box: 15. APPLICATION FEE (ONLY BANK OFFICE CHEQUE OR POSTAL MONEY ORDER WILL BE ACCEPTED) Cheque Details:
Bank Name
Bank office Cheque THE MAURITIUS COMMERCIAL BANK LTD
Bank Branch/ Post Office Branch

QUATRE BORNES
Cheque No.
71930191
Important Note : Applicants should
write their Application No. and their full name at the back of the Bank Office Cheque their
or Postal Money Order and send it to the University together with a printed and signed copy of
online Application Form only. Qualifications obtained after the closing date will not be considered .
Please use checklist provided.
20-March-2012
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16. THIS SECTION MUST BE FILLED BY ALL APPLICANTS AND COUNTERSIGNED BY PARENT / LEGAL GUARDIAN IF UNDER 18 YEARS OF AGE
I, SEEBORUTH Sanjiv ........................................................................................................................................................ declare that if admitted to the
,solemnly
University, I will diligently follow the programme of study for which I am selected to its
completion or the termination of my Registration; that I will conform to all the rules and regulations of the University and that I will inform the Registrar, in writing and without delay, if I withdraw from the programme before completion of same. I undertake, in the event of my being offered a seat at the University of Mauritius, to pay all fees as per University requirements, failing which legal action may be taken against me. I also agree that if I do not pay all fees due to the University of Mauritius, I may be denied access to examinations and/or be denied my final award certificate.
I declare that the above information is correct and I am aware that my application will be invalid and an offer of a seat, if made, will be automatically withdrawn in case of wrong information being provided and/or wrong entries.
Date:........./........./............
Signature of Applicant:.....................................................
IF UNDER 18 YEARS OF AGE
Name of Parent /Guardian:................................................................................. Date:........./........./............ Signature:...............................................................................
20-March-2012
Page 5 of 6
CHECKLIST FOR APPLICATION SUBMISSION

1 2 3 4 5 Complete set of duly filled and signe d Applica tion Form Att ach Application Fee (Bank Office Cheque or Postal M oney Order) Off e os al ey r) Re lev ant T es timonials for Mat ure ca ndida tes (Origin al) s n Copy of Cert ificates for those havin g q ualifica tions othe r t han SC and H SC io s n d C Copy of Cert ificates for Othe r Qualif icat ions a t S ection 11 a
20-March-2012
Page 6 of 6

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Rduit, Mauritius TELEPHONE:(230) 403-7400 FAX:(230) 454-9642/464-8004 Website: http://www.uom.ac.

APPLICATION FOR ADMISSION(UNDERGRADUATE)

ACADEMIC YEAR 2012/2013 1246512

Surname(in full): Other Names(in full):

Maiden name (For married Women): 2. Address for correspondence:

Home: Mobile: Office:

20, ROUTE ROYALE, LA-LOUISE, QUATRE-BORNES

Fax No. : Email: 3. Date of Birth 4. Sex 5. Marital Status

Programme Name (As advertised)

SC320 SCE321 E318 E311

GRADES (e.g. 1,2,3 or A,B,C)

GRADES (e.g. 1,2,3 or A,B,C)

Date of Attempt (Month/Year):

Subjects obtained at Principal or Advanced Level

DESIGN & TECHNOLOGY MATHEMATICS PHYSICS

Date of Attempt (Month/Year):

Subjects obtained at Subsidiary Level

GENERAL PAPER FRENCH

10. PREVIOUS OR CURRENT PROGRAMMES FOLLOWED AT UNIVERSITY OF MAURITIUS.

Have you withdrawn from any programme

From Month Year

11.OTHER QUALIFICATIONS (Any other Post-Secondary Qualifications obtained)

12. THIS SECTION SHOULD BE FILLED IN BY THOSE IN EMPLOYMENT

Name & Address of Employer /Firm

13. THIS SECTION IS RELEVANT TO NEEDY APPLICANTS ONLY

Bank Branch/ Post Office Branch

Important Note : Applicants should

Please use checklist provided.

I, SEEBORUTH Sanjiv ........................................................................................................................................................ declare that if admitted to the

IF UNDER 18 YEARS OF AGE

Name of Parent /Guardian:................................................................................. Date:........./........./............ Signature:...............................................................................

CHECKLIST FOR APPLICATION SUBMISSION

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