COMPLETE THIS FORM IN BLOCK/CAPITAL LETTERS

ZAMBEZI COLLEGE OF EDUCATION AND TECHNOLOGY
P. O. Box 150006, Zambezi. Cell: +260973004337 Email: zambeziste@gmail.com
STUDENT APPLICATION FORM
COMPLETE THIS FORM IN BLOCK/CAPITAL LETTERS
PART A: PERSONAL DETAILS
Name

First NameMiddle NameSurname
Sex
NRC/Passport No.:
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Nationality
Phone
Format: (000) 000-0000.
Email
example@example.com
Residential Address
Ward
Constituency
District
Province
SEN (Learning Disability, if any)
PART B: TRAINING PROGRAMME
SELECT ANY TWO COURSES IN ORDER OF PREFERENCE
1st Choice Programme
2nd Choice Programme
Your highest level of formal education: G7/G9/G12/GCE (Attach official transcripts)
Transcript Submitted:
DECLARATION: I,
declare that the information above is true.
Signature
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty: