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POSTGRADUATE DIPLOMA IN CURRICULUM DESIGN AND DEVELOPMENT

APPLICATION FORM

Academic year for which admission is being sought (e.g., 2012/2013) _____________

A. Personal details:

Surname/Family Name____________________________________________

Other Names_____________________________________________

Date of birth____________________________________________________

Country of birth_________________________________________________

Nationality_____________________________________________________

Permanent Address______________________________________________

Home address__________________________________________________

Phone - Landline___________________ Mobile_______________________

Fax Number___________________ E-mail Address_____________________

Employment details

Employer Position From To

Responsibilities (separate sheet may be used)

If you are admitted into the Postgraduate Diploma Programme, do you think youremployer will allow you to attend the 10-day face-to-face intensive session at theTanzania Institute of Education in Dar es Salaam, Tanzania? YES/NO

Affix two stamp size photographs

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Sponsorship Confirmation

How do you intend to finance your studies? (check the box below that applies)

Self Employer Other(s) Specify:

Name and address of your financial sponsor (if applicable)

B. Qualifications (Please enclose Transcripts, Certificates and Curriculum vitae)

Degree/Diploma Institution Year of Award

C. Please indicate below names and address of two referees, and enclose their recommendation letters with your application.

1. ____________________________________________________________________________________________________________

2. ____________________________________________________________________________________________________________

D. Please include the following with this application form:

1. Certified transcript and certificates2. CV detailing employment and employment experience3. Two passport-size photographs4. Evidence of sponsorship (or self-sponsorship)5. Letters of recommendation

Additional Information How did you learn about this Postgraduate Diploma Programme?(check the boxes that apply in your situation)

Advert in brochure Internet search

Website(s) Other(s) (please specify) _______________________________

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E. Statement of AuthenticityI hereby declare that all the information supplied is true and no attempt has been made to mislead the Institute’s admissions office. Should any cheating be discovered after admission the Institute reserves the right to nullify the admission.

Signature___________________________________ Date______________________

Send your complete application dossier before October 19, 2012 to:

The Director, Curriculum Development and ReviewTanzania Institute of Education, Box 35094 Dar es Salaam, TanzaniaE-mail: kokukunisa@yahoo.com

Successful candidates will be informed via their email address, therefore please be sure to include your email address in a legible way.

All application fees should be paid through the bank as follows: Bank name: CRDB Bank LimitedA/C Name: Tanzania Institute of Education, Curriculum Training A/C.

A/C Number: 0250013986401Country: TanzaniaSWIFT code: CORUTZTZ