OFFICE OF THE ACADEMIC REGISTRAR

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OFFICE OF THE ACADEMIC REGISTRAR
This form should be completed and returned to:
The Academic Registrar
Nkumba University
Location: Kampala-Entebbe Highway 27km
P.O Box 237 Entebbe – Uganda
Telephone: +256-0414-374996/ +256-0414-320283
+256-0414-321448
E-mail: [email protected]
Website: www.nkumbauniversity.ac.ug
Attach current passportsized photograph here
APPLICATION FOR ADMISSION TO UNDER-GRADUATE STUDY PROGRAMMES
PLEASE FILL THIS FORM IN CAPITAL LETTERS USING EITHER BLUE OR BLACK INK
NOTE:
Please attach CLEAR copies of both ‘0’ level and ‘A’ level result slips/Certificates. Transcripts and Certificates of any
other qualifications such as Ordinary Certificates and Diplomas MUST be CERTIFIED by the awarding Institution. Include
a copy of the birth certificate to this form.
All academic records in a language other than English must be accompanied by a Translated and Certified English
translation. The copies must then be equated by UNEB and/or NCHE at Kyambogo
.
Initially the selection letter for admission for those who qualify is provisional. It does not give the applicant an entitlement
to a place at Nkumba University. Originals shall be required for verification at the time of registration.
1. Academic programme applied for and the study session;
Day/Eve/Wkd/DL
st
1 Choice
nd
Choice
nd
Choice
2
3
1.
Intake: (Tick your choice)
August Intake
2. Study centre
February Intake
/ Campus (Tick your choice)
Nkumba Main Campus
Kampala Campus
3. Applicants Personal Details
3.1 Name:
Surname:
(As Name appears on academic documents)
Other Name:
3.2 Title: (Rev., Sis., Dr., Mr., Mrs.,Ms.)
3.3 Gender: (Male or Female)
3.4 Date of birth/Age
3.5 Country of Residence
Date of birth (dd/mm/yyyy):
Age:
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3.6 Country of Birth
3.7 Nationality
3.8 Religious Affiliation
3.9 Marital Status
Mobile Tel No:
3.10 Applicants Contact:
E-Mail Address:
Postal Address:
4. Parents l Guardians Information
4.1 Relationship: Father / Mother /
Other (Indicate Name)
4.2
Occupation:
4.3
Physical Address:
4.4 Telephone contact:
4.5 Email address:
5. Source of information
How did you learn about Nkumba University, and the programme(s) you are applying for?
□ b) Internet Search / University Website □
c) Radio / TV Advertisement □ d) Social Media □ e) Career Talk/ Guidance Counsellor □
e) Current Student / Alumni □ f) Other:............................................................. □
a) Print Advertisement
6. Education Background:
(Secondary Schools/Colleges/Special training taken (Give names, dates and qualifications and attach
copies of Academic documents)
Name and address of school/institution
From
To
Qualification
CATION BACKGROUND
7. Declaration by Candidate:
I ………………………………………………………………. Declare that the information given
above is true to the best of my knowledge.
Signature…………………………………………………. Date ……………………………………