PASSPORT SIZE
MAHINYA TRAINING CENTRE
FOR SUSTAINABLE AGRICULTURE
P.O. Box 1282, Songea, Ruvuma, Tanzania
APPLICATION FORM FOR ADMISSION TO
“ANIMAL HUSBANDRY - LEVEL ONE PROGRAMME” FOR 2015 ACADEMIC YEAR
One copy of this form, when completed, must be sent to the COURSE COORDINATOR, MAHINYA TRAINING
CENTRE FOR SUSTAINABLE AGRICULTURE, P.O.BOX 1282, SONGEA, RUVUMA TANZANIA, after paying a
non refundable application fee of Tshs 15,000/= through Account No. 01J1093812800 CRDB BANK - SONGEA
BRANCH (ACCOUNT NAME: COPE SAAFI)
FOR OFFICIAL USE ONLY:
APPLICATION FEE RECEIPT No:__________________APPLICATION FORM No:_______________________
APPLICANT MEETS ENTRY REQUIREMENT FOR____________________________________PROGRAMME
1.0 PERSONAL DETAILS
(Write in Capital Letter)
1.1 First Name:__________________________________ Middle Name:__________________________________
Last Name:______________________________________________ SEX (M/F): ___________________________
(The names entered in this form must be exactly the same as those on your C.S.E.E. or other academic certificates)
1.2 Date of Birth (Attach Copy of Birth Certificate):________________ Place:______________________________
Country: ___________________________________ Nationality: ________________________________________
1.3 Permanent contact address: ____________________________________________________________________
Tel. Home: ____________________ Office: _____________________ Mobile:_____________________________
E-Mail: ______________________________________
1.4 Name and Address of Sponsor:_________________________________________________________________
Tel. Home: ____________________ Office: _____________________ Mobile:_____________________________
Fax: _________________________________________E-Mail:__________________________________________
Note: Deadline for receiving fully filled application form is 15/12/2014
2.0 EDUCATION BACKGROUND
2.1 Advanced Certificate of Secondary Education Examination (A.C.S.E.E.) Form Six or Equivalent
SUBJECT
GRADE
DATE
INDEX No
Division/Class: __________________________________Examining Authority: ____________________________
Examination Centre or School: _____________________________ Country:_______________________________
2.2 Certificate of Secondary Education Examinations (C.S.E.E.)/National Form Four/or Equivalent.
SUBJECT
GRADE
DATE
INDEX No
Division/Class: __________________________________Examining Authority: ____________________________
Examination Centre or School: _____________________________ Country:_______________________________
3.0 EMPLOYMENT RECORD
Please give details of your employment record in the table below
S/N
Name of Employer
Position Held
Dates (eg from-to-)
4.0 ATTACHMENTS
Your application form MUST be submitted together with the following attachments:

Certified Copies of Academic Certificates

Certified Copy of Birth Certificate. Affidavit and Deed Polls ARE NOT ACCEPTED (unless published in
the government gazette)

One Passport Size Photograph firmly affixed to the application form.

Original Receipt of Application Fee/Bank Pay-in-Slip/Postal Money Order. All these should indicate the
name of the CANDIDATE and name of PROGRAMME applied for.
5.0 DECLARATION
I _________________________________________ (your full name) do hereby confirm, to the best of my
knowledge, that the information given in this form and the attachments are correct and complete.
I understand that submission of false documents/information is a criminal offence punishable in a Court of Law.
Place___________________________ Date_________________________
Signature of Applicant
________________________
NOTE:
 INCOMPLETE APPLICATION FORMS SHALL NOT BE PROCESSED
 SUBMISION OF FALSE INFORMATION OR RECORDS SHALL LEAD TO CRIMINAL
PROSECUTION
 RESULT SLIPS WILL BE ACCEPTED ONLY FOR THOSE WHO COMPLETED THEIR STUDIES IN
2014 FOR FORM FOUR AND FORM SIX
 DULLY FILLED FORMS SHOULD BE SUBMITTED TO THE COURSE COORDINATOR MAHINYA
TRAINING CENTRE FOR SUSTAINABLE AGRICULTURE P.O. BOX 1282, SONGEA RUVUMA,
TANZANIA
 DEADLINE FOR RECEIVING DULLY FILLED APPLICATION FORMS IS: 15/12/2014
MAHINYA TRAINING CENTRE FOR SUSTAINABLE AGRICULTURE
FEES STRUCTURES FOR THE ACADEMIC YEAR 2015/2017
TUITION FEE
MEALS AND
ACCOMODATION
COUTION MONEY
EXAMINATION FEES
BOOKS AND STATIONARIES
MEDICAL CAPITATION
STUDENTS ORGANIZATION
TOTAL DIRECT COST
YEAR 1
420.000
520.000
YEAR2
500.000
600.000
YEAR3
500.000
600.000
20.000
20.000
15.000
40.000
5.000
1.040.000
20.000
20.000
15.000
40.000
5.000
1.200.000
20.000
20.000
15.000
40.000
5.000
1.230.000
NOTE:






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The students will be registered after meet the payment of at least 60% of the total direct cost (i.e. 60% of
Tshs 1.040.000 for the start of year 1 and the same to the total direct cost of the second year)
The remaining 40% must be paid at the start of the second semester of the particular year.
Caution money will be refunded at the end of the course if and only the student does not caused damage or
loss of the centres properties
Students who want to undergo field for level one course in animal husbandry, costs associated with such
field will be paid by the student at his or her own cost. The centre may provide the student with the field
request letter if required. Field attachment will be allowed during holidays.
MEDICAL CAPITATION IS COMPULSORY FOR ALL STUDENTS and MUST BE PAID ON
REGISTRATION AT THE CENTRE. If you are already a member of national health insurance fund
(NHIF) or other security funds you will be required to pay Tshs 20,000/= only to the centre to cover for
other expenses which are not covered by such security funds.
Tuition fee paid for that particular academic year, and it is subjected to review from time to time when
needs arises.
All payment must be done through bank account Number 01J1093812800 ACC NAME COPE SAAFI
and submit the bank payslip at the date of registration.