AFRICA INLAND CHURCH TANZANIA
HEALTH DEPARTMENT
Affix recent
KOLANDOTO COLLEGE OF HEALTH SCIENCES
photograph
P.O. Box 16 KOLANDOTO, Tel: +25742155623 Fax: +255(0)732987360
E-mail: [email protected]
website: www.kchs.ac.tz
REG.NUMBER: REG/HAS/008
APPLICATION FORM FOR ACADEMIC YEAR 2017/2018
Instruction:
Fill using blue or black ball point pen in CAPITAL letters
Write your names as it appear
First name
Middle Name
Last name
Nationality
Date of Birth
Place of birth (District)
in your form four certificate
Sex
Place of domicile (home district):
Phone Number
Primary School:
Email:
Name of secondary school attended (O-level):
Year completed form four:
Index number:
Name of Advance school attended (A-level)
Year completed form six:
Index number:
College completed NTA level 5 (for upgrading student) :
Year completed NTA level 5 (for upgrading student):
Indicate grades score for each of the following subjects in the national form four and form six examinations and
attach copy of your academic certificate
Form four
Form six
Form four
Form six
Physics
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Geography
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Engineering Sc.
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Kiswahili
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Chemistry
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History
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Biology
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Civics
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Mathematics
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Agriculture
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English
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Economics
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Mention the name of the course you are applying for : First choice:
Second choice:
Third choice:
Applicants correspondence address:
Name of Parent/Guardian/Employer
Postal Address:
Phone number:
Email:
I declare that the information provided in this form is true. I understand presentation of false information
lead to disqualification and legal actions against me.
Applicant Signature:……………………………..
Date………/…………/20………
Deadline for application is 20/8/2017
PROGRAMMES OFFERED BY INSTITUTION IN 2017/2018
S/N
PROGRAM NAME
ADMISSION REQUIREMENTS
1
Technician Certificate in
Nursing
Holders of Certificate of Secondary Education Examination (CSEE) with four (4)
passes in non-religious subjects including "C" passes in Chemistry and Biology; and
"D" passes in Physics/Engineering Sciences and English Language, pass in Basic
Mathematics is an added advantage.
Holders of Certificate of Secondary Education Examination (CSEE) with four (4)
passes in non-religious subjects including "C" passes in Chemistry and Biology; and
"D" passes in Physics/Engineering Sciences and English and pass in Mathematics will
be added advantage.
2
Ordinary Diploma in
Nursing(PRE SERVICE)
3
Ordinary Diploma in
Nursing (In Service)
Holder of Technician Certificate (NTA level 5) in Nursing with "D" pass in Biology, Chemistry or Physics
(CSEE) for the graduates starting from 2010; OR Graduates before NTAs system should have certificate in
Nursing and Midwifery/Public Health Nurse B and at least "D" Pass in any of science subject;
Work experience of two (2) years and above, Necessary Attachments: Register and License to practice by TNMC,
Technician Certificate and Transcript in the related field and Letter of permission from employer.
4
Basic Technician
Certificate in Community
Health
5
Technician Certificate in
Medical
Laboratory
Sciences
Ordinary Diploma IN
Medical Lab. Technology
(PRE SERVICE)
Technician certificate in
Clinical Medicine
8
Ordinary Diploma in
Clinical Medicine(PRE
SERVICE)
Holders of Certificate of Secondary Education Examination (CSEE) with four (4) passes in
non-religious subjects including "D" pass in Biology OR An applicant who has received
informal training in Community Health Workers (CHWs), Para Social work (PSW) and
Medical Attendant (MAs) recognized programs; and practiced in the respective area AND
Holder of Certificate of Secondary Education Examination OR Advanced Certificate of
Secondary Education Examination.
Admission of such applicants into the programme will follow guidelines and procedures for
Recognition of Prior Learning (RPL) prescribed by NACTE; Necessary Attachments: Birth
Certificate, Letter from Village Executive Officer (VEO) and Certificate for CHWs, PSWs
or MAs training (if attended).
Holders of Certificate of Secondary Education Examination (CSEE) with five (5) passes in
non-religious subjects including D passes in Chemistry, Biology, Physics/Engineering
Sciences, Mathematics and English
Holders of Certificate of Secondary Education Examination (CSEE) with five (5) passes in
non-religious subjects including C passes in Chemistry and Biology; and D pass in
Mathematics, Physics/Engineering Sciences and English
Holders of Certificate of Secondary Education Examination (CSEE) with five (5) passes in
non-religious subjects including D passes in Chemistry, Biology, Physics/Engineering
Science, Mathematics and English
Holders of Certificate of Secondary Education Examination (CSEE) with five (5) passes in
non-religious subjects including C passes in Chemistry and Biology; and D pass in
Mathematics, Physics/Engineering Sciences and English
9
ORDINARY DIPLOMA
Holder of Technician Certificate (NTA level 5) in Clinical Medicine with "D" pass in
IN CLINICAL
Biology, Chemistry or Physics (CSEE) for the graduates starting from 2010; OR Graduates
MEDICINE
before NTAs system should have certificate in Clinical Medicine and at least D Pass in any
(UPGRADING)
of science subject; Necessary Attachments: Technician Certificate and Transcript in
6
7
Clinical Medicine and Letter of permission from employer for graduates before 2015.
10
ORDINARY DIPLOMA
Holders of Technician Certificate (NTA level 5) in Medical Laboratory Sciences
IN MEDICAL
trained from Health Training Institution recognized by the Ministry of Health,
LABORATORY
Community Development, Gender, Elderly and Children with "D" passes in Biology
SCIENCES (IN
and Chemistry in Certificate of Secondary Education Examination (CSEE) ; OR
SERVICE)
Holders of Certificate in Medical Laboratory Sciences trained from Health Training
Institution recognized by the Ministry of Health, Community Development, Gender,
Elderly and Children with "D" passes in Biology and Chemistry in Certificate of
Secondary Education Examination (CSEE) awarded before 2012: Necessary
Attachments: Technician Certificate and Transcript, License to practice and Letter of
permission from employer.