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Makerere University University of Nairobi(Higher Diploma in Vet Science) (Bsc in DEAM)

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APPLICATION FORM FOR 2013/2014 ACADEMIC YEAR

Courses Details:

A University of Nairobi accredited BSc Course in Dry-land Economics andAgro-ecosystem Management (DEAM) / Agricultural Economics with 3 options:

The first two years of the BSc Agriculture program will be spent on core courses which willground the students in Dry-land agriculture related basic science and the fundamentals of the

professional agricultural disciplines. In the third year of the course, the students will opt and specialize in any of the following majors :

Dry land Agriculture Economics MajorExtension and Communication MajorLand and Water Resource Management Major

A Makerere University accredited Higher Diploma course in Veterinary Sciences

A three years full fledged Higher Diploma course in animal sciences with the first two years grounding studentsin pre-clinical studies, and the third year specializes in either Livestock Health Sciences (DLH) or Livestock Prod-

uct Development and Entrepreneurship (DLDE).

Course Application Details:

Tick the Course you are applying for:

A) BSc in Dry-land Economics and Agro-ecosystem Management (DEAM) / Agricultural Economics

B) Higher Diploma in Veterinary Sciences ( DLH / DLPE)

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IDENTIFICATION

Full Name: ...

Date of Birth: Gender: M F

Place of birth: .

Nationality: .

Fathers name:

Mothers name:

CONTACT ADDRESS

Address, (as precise as possible): .....................

...........................................................................................................................................................................

Telephone : ..

P.O. Box (where applicable) : .

Email address : .

EDUCATION

Type of certificate : ICGSC. A level.. Other.

Year of completion of secondary school certificate: ..

Country in which the certificate was obtained :

Foreign language 1:. Foreign Language 2: .

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SECONDARY SCHOOLS ATTENDED

DOCUMENTS TO BE ATTACHED TO THIS FORM

1. A copy of secondary school leaving certificate (specifying individual subject grades) or if in final year

of secondary school, a copy of school enrolment or exam ID or authenticated letter specifying the

school you are attending

2. A copy of transcripts of the last two years of the secondary school

3. A valid contact address (Email/Phone) of the secondary school attended

APPLICANTS DECLARATION

I declare that the information given herein is true and accurate to the best of my knowledge and fully un-derstand that any information found to be false would lead to automatic disqualification.

Applicants Full Name:

..

Date . Applicants Signature ...

Form Name of School Year of attendance Results

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THIS FIELD IS ONLY FOR ISTVS ADMINISTRATION

Candidates name: ..

Candidate Roll Number at ISTVS entrance exam: .

Validation of Application :Accepted

Exam centre: .

RejectedReason:.

Signature of Admission Officer

Date ,..