GREAT ZIMBABWE UNIVERSITY
BOX 1235
MASVINGO
Tel+263 39 2266 648,58,60,62
                                     08677004747

		
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READ INSTRUCTIONS ON PAGE 3 BEFORE COMPLETING THE FORM
 POSTGRADUATE ADMISSION APPLICATION FORM 20

INTAKE:  JANUARY            FEB/MARCH                      APRIL                       JULY                         AUGUST

COHORT: (For Block/Weekend Classes) BULAWAYO                   HARARE            MASVINGO

1.  PERSONAL DETAILS                                                              

SURNAME:                _________________________________   	FIRST NAME:                 ________________________________________
DATE OF BIRTH:       _________________________________    PLACE OF BIRTH:         ________________________________________	
SEX:                          _________________________________     TITLE:  (Mr,Mrs,Miss etc.)    _____________________________                   MARITAL STATUS:   _________________________________     PREVIOUS SURNAME (IF ANY):________________________________               NATIONAL I.D.:         _________________________________     RACE:                             _______________________________________                    NATIONALITY:          ________________________________	CITIZENSHIP:                  ______________________________________
PROVINCE:               ________________________________      RELIGION:                      _______________________________________                                                                                 
	YES	NO	IF YES TYPE AND /OR ATTACH PROOF	
ANY PHYSICAL DISABILITY				
				        
2. CONTACT DETAILS (All correspondence will be forwarded to the Physical Address)                                                            

PHYSICAL ADDRESS:   ______________________________     NEXT OF KIN’S NAME:   ________________________________________                                                             _                                       ______________________________    RELATIONSHIP               ________________________________________                                                            ______                             ______________________________    NEXT OF KIN ADDRESS:________________________________________
__                                     ______________________________ 	                 RELI                 ________________________________________    
 CELL/ TEL:                     ______________________________	________________________________________
Email Address:                ______________________________     CELL/ TEL:                      ________________________________________

3.  PROGRAMME CHOICES (PLEASE INDICATE PROGRAMME AND AREA OF SPECIALISATION (IF ANY), NB: turn to page 4 for programmes)

FIRST CHOICE PROGRAMME:      _________________________________________________________________________

SECOND CHOICE PROGRAMME:  _________________________________________________________________________

TICK APPROPRIATE 
                      
ENTRY TYPE :     NORMAL 	                 MATURE	                        SPECIAL

INTAKE TYPE :    FULL TIME	PARALLEL	                            BLOCK RELEASE	WEEKEND SCHOOL
 
 SPONSORSHIP: GOVERNMENT	 SELF                                     OTHER………………………………………………………….................
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FOR OFFICE USE ONLY

RECEIPT NUMBER:               …………………………………..                                                DATE OF RECEIPT:………………………………………………………

						
					
4.  ACADEMIC HISTORY

ORDINARY LEVEL AND ADVANCED LEVEL

MONTH         YEAR
(EG. 11/04)	EXAMINATION BOARD
(EG. ZIMSEC, AEB)	‘O’ LEVEL	SUBJECT	RESULT/
GRADE	
			MATHEMATICS		
			ENGLISH		

					

					
		‘A’ LEVEL			

					

4.1	UNIVERSITY AND POST SCHOOL LEAVING STUDIES

COLLEGES/UNIVERSITY (IF OUTSIDE ZIMBABWE GIVE ADDRESS)
DATE OF AWARD	PROGRAMME UNDERTAKEN
DEGREE/DIPLOMA/CERTIFICATE	NAME OF UNIVERSITY/
COLLEGE	DEGREE CLASS	

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ADDRESS (IF OUTSIDE ZIMBABWE):    ____________________________________________________________
				    ___________________________________________________________
CELL/TELEPHONE		   ___________________________________________________________
					                                                
5.  EMPLOYMENT HISTORY
GIVE DETAILS OF EMPLOYMENT AND EXPERIENCE
COMPANY/INSTITUTION	OCCUPATION	JOB DESCRIPTION/DUTIES	FROM	TO	

=======================================================================================	
ARE YOU UNIVERSITY STAFF OR DEPENDENT (i.e. wife, husband or child)	
IF ‘YES’ PLEASE GIVE NAME, DEPARTMENT AND TELEPHONE
..........................................................................................................................................................................................................................................................................................................................................................................................................................

6.  REFEREES

1.  NAME:       __________________________________	2.  NAME          _____________________________________
   
     ADDRESS _________________________________                     ADDRESS    ___________________________________
        	        __________________________________	                    ____________________________________
    CELL/TEL:   __________________________________                 CELL/TEL:      ___________________________________

		

7.  DECLARATION

I DECLARE THAT THE INFORMATION THAT I HAVE GIVEN IS CORRECT, AND THAT SHOULD IT BE FOUND TO BE FALSE; MY APPLICATION WILL BE DISQUALIFIED AND WILL FACE LEGAL ACTION.  I HEREBY AGREE TO BE BOUND BY CONDITIONS OF APPLICATION, TO SIGNIFY WHICH I HEREBY ADDEND MY SIGNATURE.

DATE:	_______________________	                                          SIGNATURE:  _____________________________________

8.  CHECKLIST AND INSTRUCTIONS
Attach photocopies of all certificates.
Please fill in all pages. Subsequent to completing your application form please attach certified copies of the following documents:
1.	National ID 2. Birth Certificate 3. ‘O’ and ‘A’ Level certificates
4. Professional Certificates (if any) 5. Marriage Certificate (where applicable)
Application forms are available from website www.gzu.ac.zw.  Submit the downloaded form together with application fees as advertised in the paper and submit before closing date of advertised programmes and for late entries please refer to the advert.
                                                                                                                                                                                                                YES   NO
8.1	  I HAVE COMPLETED ALL SECTIONS OF THE FORM
8.2	  I HAVE ENCLOSED CERTIFIED COPIES OF ALL DOCUMENTS
8.3	  I HAVE SIGNED THIS FORM
            NB:       ONLY SUCCESSFUL CANDIDATES WILL BE CONTACTED

TO VIEW ALL POSTGRADUATE DEGREE PROGRAMMES, VISIT THE UNIVERSITY WEBSITE AND CHECK FOR THE LATEST ADVERT