COLLEGE OF SCIENCE AND TECHNOLOGY

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COLLEGE OF SCIENCE AND TECHNOLOGY BP 3900, Kigali, Rwanda. Email: DPGDS.CST@ur.ac.rw APPLICATION FOR POSTGRADUATE STUDIES Instruction to Candidates: ACADEMIC YEAR 2015/2016 Affix a passport size colour photograph with white background Before you fill the application, please read the instructions carefully Attach separate pages, if you need more spaces Forms can be downloaded from our web site www.cst.ur.ac.rw Two coloured passport size photographs with white back ground (no scanned photographs) Certified photocopies of Degree and Academic records/transcripts (Not scanned) Motivation letter for applying to the programme and specialization Referee Reports should be filled by your referees and returned together with your application Certificate of experience (if required in admission requirements) from your employer A non-refundable application fee of Frw 10,000 must be paid into the UR-CST account in Bank of Kigali Account No.: 00094 0651935 36 or I&M(Rwanda)Bank, Account No.: 00010 5044380 07 78 Filled application form together with required supportive document dully signed should reach the following address: 1. NYARUGENGE Campus The Academic Office or Secretariat of Directorate Postgraduate Studies, Research and Publications UR College of Science and Technology, BP 3900, Kigali, Rwanda 2. HUYE Campus Office of Head of Department hosting PG programme PART A: Indicate your choice of Programme for Admission: 1

Section B: PERSONAL DETAILS SURNAME FIRST NAME DATE OF BIRTH DD MM YYYY Marital Status: Married Single Gender: M F Tick the appropriate circle NATIONALITY ID/ PASSPORT No: HOME POSTAL ADDRESS WORK POSTAL ADDRESS (if different) Fax: Email Fax: Email Name and Address of Sponsor: Telephone Number: Section C: ACADEMIC BACKGROUND (Start with latest attended) List schools, colleges and universities attended beginning with the most recent. Attach certified photocopies of certificates and transcripts obtained. Name and Address of School/College Period [Year] From To Main Subjects Grade Obtained Examination Authority/Board 2

Section D: PROFESSIONAL EXPERIENCE [If any] (Start from the present employer) Period: From: To: Name of the Employer Dept, Division or Regional Office name: Job Title: City: Postal Code: Country: Telephone: Fax: Email: Description of your work indicating your personal responsibilities: Attach additional sheets for more information Period: From: To: Name of the Employer Dept, Division or Regional Office name: Job Title: City: Postal Code: Country: Telephone: Fax: Email: Description of your work indicating your personal responsibilities: Attach additional sheets for more information 3

Section E: REFEREES Give names and addresses of two referees, one of whom must be the head of your last school or your teacher. The Two referees must fill the referee report appended to this application form and send it to the Admissions Office separately. Name: Name: Email: Email: Section F: DECLARATION I hereby declare that the particulars furnished above are true and correct to the best of my knowledge. Signature. Date:.. FOR OFFICE USE ONLY To be completed by the Admissions Officer ACTION Admitted (specify program) Admitted conditionally (state conditions) Application rejected (state the reason) Name and Signature of the Admissions Officer REMARKS 4

COLLEGE OF SCIENCE AND TECHNOLOGY BP 3900, Kigali, Rwanda. Email : info@kist.ac.rw/dpgds@kist.ac.rw Dear Sir/Madam REFEREE REPORT [FROM ACADEMIC SOURCE] Date : The candidate named below has put forward your name as his referee. Please kindly furnish us with the requested information by filling this form. Name of the Candidate Course for which the Candidate is seeking admission For how long have you known the candidate? How are you related to the candidate? In your judgment, what is your rating on the candidates linguistic abilities? French Language Excellent Good Fair Poor English Other(s), if any, specify: How do you rate this candidate s ability to pursue a degree program specified above? Name of Referee: Fax: Email: I certify that the information given above is correct to the best of my knowledge. Place: Date: Signature 5

COLLEGE OF SCIENCE AND TECHNOLOGY BP 3900, Kigali, Rwanda. Email : info@kist.ac.rw/dpgds@kist.ac.rw Dear Sir/Madam REFEREE REPORT [FROM NON- ACDEMIC SOURCE OR EMPLOYER] Date : The candidate named below has put forward your name as his referee. Please kindly furnish us with the requested information by filling this form. Name of the Candidate Course for which the Candidate is seeking admission For how long have you known the candidate? How are you related to the candidate? In your judgment, what is your rating on the candidates linguistic abilities? French Language Excellent Good Fair Poor English Other(s), if any, specify: How do you rate this candidate s ability to pursue a degree program specified above? Name of Referee: Fax: Email: I certify that the information given above is correct to the best of my knowledge. Place: Date: Signature 6