Chalimbana Local Government Training Institute
(Bachelors's Degree Application Form)
Name
*
First Name
Last Name
Chalimbana Local Government Training Institute
Date of Birth
DD/MM/YY
E-mail
*
example@example.com
Date of Birth
-
Month
-
Day
Year
Date
Phone Number
*
-
+260
Phone Number
Gender
*
Please Select
Male
Female
Marital Status
*
Please Select
Single
Married
Divorced
NRC Number
*
Postal Address
Residential Address
*
Last Secondary school/Institution Attended. (Give dates.)
*
Name, Address and Telephone Number(s) of next of Kin.
*
If you are currently engaged in any studies, please state the nature and type of studies and qualification being sought.
Do you have any physical or communication disabilities? if yes please tick.
Vision
Mobility
Speech
Hearing
Other
Which Programme are you applying for?
*
Bachelor of Art in Local Government Finance
Bachelor of Art in Public Administration
Bachelor of Art in Governance and Development
Bachelor of Art in Developmental Planning
Fill in this part if you are presently employed. Type of employment, name of employer, address of employer and period of service.
Upload Proof of Payment
*
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Upload the following: 1. NRC/Passport 2. Grade 12 certificates 3. Other Relevant Documents.
*
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