Student Application Form

Transcription

1 2017 LI MPOP OOFF LI MPOPOO Y UUN NI IVVEERRSSITITY Student Application Form Under - Graduate Post - Graduate Central Enrolment Contacts: University Registrar University of Limpopo Private Bag X1106 Sovenga, 0727 Tel: / 2812 / 2788 / 3276 Fax:

2 VISION To be a leading African University focused on the developmental needs of its communities and epitomising academic excellence and innovativeness MISSION A University which responds actively: To the development needs of its students, staff and communities, Through relevant and higher quality education and training, research and community engagement, and In partnership and collaboration with its stakeholders. VALUES Accountability Transparency Integrity Academic Freedom Excellence and Professionalism Finding solutions for Africa Page -1-

3 GUIDELINES FOR APPLYING TO STUDY AT THE UNIVERSITY OF LIMPOPO 1 GENERAL APPLICATION INFORMATION 1.1 University of Limpopo paper-based applications open on 1 March Each prospective student must complete only one application form. On the application form, kindly indicate your first and second choice in terms of what you wish to study. 1.3 Once your application form has been processed, you will receive an acknowledgment letter, with a reference number. 1.4 If on the basis of the results you submitted (either Grade 11; Grade 12, etc.) you are deemed to be meeting the minimum entry requirements for the programme you wish to study for, you will be issued with a provisional acceptance letter, which merely says you will be accepted into the programme, subject to your final National Senior Certificate results. 1.5 Receiving either an acknowledgment letter or provisional acceptance letter does not imply that you have been accepted by the University of Limpopo yet. Admission is a separate process that your application undergoes after being evaluated by the relevant Faculty. 2 HOW TO FILL IN THE APPLICATION FORM? 2.1 The form must be completed in full. Ÿ Ÿ The paper-based application form, when submitted, must be accompanied by: All relevant supporting documentation 2.2 Proof of bank payment fee of R200 for South African students and R300 for international students. 2.3 For your own protection, cash should not be included when posting application to the University of Limpopo. 2.4 Your paper-based application form must be posted to: Registrar University of Limpopo Private Bag X1106 SOVENGA The University of Limpopo reserves the right to reject or withdraw your application if you provide incorrect, Page -2-

4 Student Application Form incomplete, illegible or fake documents. 2.6 Please check the following on your application form before posting it to the University: 1 Application fee: Is your proof of payment attached? 2 Are certified copies of all the relevant documents attached? 3 Did you complete your application in full? 4 Did you indicate the name of study programme you wish to apply for? 5 Did you provide information about your parent / guardian or next of kin? 6 Did you provide your ID number/copy, physical and postal addresses? 7 Did you submit the application form by the closing date, i.e. 27 September GENERAL INFORMATION RELATING TO ON- CAMPUS RESIDENCE APPLICATION 3.1 To apply for a place in the University Residences, please complete the last section of the APPLICATION FORM. 3.2 Please note that indicating that you require a place in the University residence does not guarantee you a place in the residence. The University has limited student accommodation capacity. 3.3 A selection process has to take place, and priority is given to applicants who have obtained outstanding academic results. 3.4 No student will be admitted to the residence until s/she has been academically admitted to a programme and before appropriate fees have been paid. 3.5 On-Campus Residence is limited and preference to applications received on or before the closing date for applications. 3.6 Late applications will not be considered for On-Campus Residence. Page -3-

5 Student Application Form International Applicants R (Three Hundred and Forty Five Rands) SA Nationals R (Two Hundred Rands) NON REFUNDABLE APPLICATION FEE MUST BE PAID AND THE DEPOSIT SLIP ATTACHED TO THE APPLICATION FORM UPON SUBMISSION BANKING DETAILS: Bank: Standard Bank Account holder : University of Limpopo Branch: Polokwane Branch number : Account number : REF Your: SA ID/Passport No & country: Campus Turfloop Student Number Academic Year 2017 A ACADEMIC DETAILS 1. Qualifications you intend to follow(e.g. B.A, MBChB, B.Sc, Bcom) Degree/Diploma Study level 1 st Choice 2 nd Choice 2. Mode of study Full Time For office use Part Time For office use Block Release B PERSONAL DETAILS OF THE APPLICANT 3. Title 4. Initials 5. Surname 6. Maiden Name 7. Full Names 8. Identity Number (RSA) 10. Passport Number (International Students ) 9. Date of Birth 11. Passport Expiry Date Page -4-

6 Student Application Form 12. Marital Status 13. Gender 14. Home Language /Mother Tongue 15. Religion/Church Affiliation 16. Occupation 17. Physical Impairment (e.g. Blind (see also page 5)) 18. Residential or Physical Address (Not the School Address) (e.g. Ga - Ramongwane, Moletjie, Limpopo Province) 19. Postal Address 20. Telephone No. (International Code) Fax No. Code Code (International Code) Cell No. (International Code) C DETAILS/ HEMIS ( This information is Compulsory) 21. Citizenship/ 22. Ethnic Nationality Group/ Race 23. Province/ State 24. Rural/ Urban/ Peri - Urban D 25. Examination Date MATRICULATION DETAILS / SECONDARY SCHOOL LEAVING 27. Examination No. 28. Senior Certificate Type (e.g. National Senior Certificate or National Certificate) 29. School Name 26. Highest Grade / Level (Standard if applicable) 30. Examination Department( e.g. Limpopo) or Examination Body (e.g. IEB) 31. Last Examination Grade 11 June Grade 12 Dec Grade 12 Other (Please Specify) Page -5-

7 Student Application Form 32. Subjects and results of last examination Subject Code Level Symbol E POST-SCHOOL ACADEMIC ACTIVITIES 33. Were you previously registered at this or another institution of higher learning? If yes, please supply the following information. Yes Institution Student Period Was the qualification Number From To completed? No If yes, when?(year) Yes Yes No No 34. If you have not been at institutions of high learning after matriculating, what activities have you been engaged in? 35. Have you previously been excluded from any institution of higher learning? If yes, supply the following information. Name of Institution Yes Qualification excluded from Date and period of Date Period exclusion Grounds for exclusion(academic, financial or disciplinary) F ON-CAMPUS RESIDENCE APPLICATION (OPTIONAL) 36. Would you like accommodation on campus Yes No Student housing with catering Yes No NB: Applicants are advised that accommodation on campus is not guaranteed Page -6-

8 Student Application Form G FINANCIAL AID (OPTIONAL) 37 Would you like financial assistance Yes No N.B. Applicants should note that financial assistance is not quaranteed I PARTICULARS OF PARENTS/GUARDIAN/SPOUSE OR NEXT OF KIN 38. Title Initials Surname Relationship ID Number (RSA) 39. Residential Address (not postal address) 40. Postal Address Code Code 41. Please specify which address you want financial statements to be send to (e.g. Residential or Physical) 42. Contact Numbers Work Home Cellphone 43. Is your parent/guardian or spouse, a staff member of the University of Limpopo? If yes, indicate his/her Staff Number Yes No 44. Are you a staff member of the University of Limpopo? Yes No Staff No. H DECLARATION I (full names) hereby declare that All the information provided in this document is true a nd that I will abide by all the rules and regulations of the University of Limpopo. I have concluded this agreement with the knowledge and consent of my parents/guardian/spouse or next of kin. Page -7-

9 Student Application Form Signed at on the day of 20 Signature of Applicant Date: Signature of Parents/Guardian/Spouse Date: Are you a person living with a disability? Yes No Tick the nature of disability Sight (Condition corrected with spectacles are not applicable) Hearing even with hearing aid Intellectual (Difficulties in learning) Multiple Communication (Talking, Listening) Physical (Moving, Standing) NB: Please provide more information if you ticked any of the above. FOR OFFICE USE Documents to accompany the Application Form School Leaving / Matric certificate Degree certificate Diploma certificate Academic transcript Two ID/Passport Photos Testimonial / Certificate of Conduct Universities South Africa (HESA) / SAQA evaluation Certificate Certified copy of Identity document/passport School results Marriage certificate Name of Officer : Signature : OFFICE STAMP Page -8-

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11 APPLICATION FOR ON-CAMPUS RESIDENCE 2017 Title: Surname and Initials: REF NO: Date of Birth: ID No: Gender: Home Language: Preferred language for correspondence: Degree (e.g. BA) Are you a person living with a disability? Yes No Tick the nature of disability Sight (Condition corrected with spectacles are not applicable) Hearing even with hearing aid Communication (Talking, Listening) Physical (Moving, Standing) Intellectual (Difficulties in learning) Multiple NB: Please provide more information if you ticked any of the above. Home / Residential Address: Postal Code Telephone Number: Home: Cell Phone: Address: Page -9-

12 SECTION B: PARENT / GUARDIAN S DETAILS Mr / Mrs / Prof. / Dr. Surname & Initials: ID Number Residential Address: Cell phone Number: Work: Home: Address: ESSENTIAL INFORMATION (PLEASE READ) 1. This serves as proof that you have applied for residence accommodation 2. This application does not guarantee you a place in the residences. 3. The closing date is (27th September 2016). Signature of Applicant Date: SECTION C: FOR OFFICE USE ONLY Approved Name of residence Room Number Waiting List REF NO: 2017 Signature: Dean of Student Affairs / Director of Student Housing Page -10- Date