FORM NO.:.....................................
(For Office Use Only)
Photograph
NAME OF APPLICANT:............................................................
(Surname first eg. Mensah Kofi)
Index Number of Previous GIMPA Student:………………….
GHANA INSTITUTE OF MANAGEMENT AND
PUBLIC ADMINISTRATION (GIMPA)
Motto: Excellence in Leadership, Management and Administration
GIMPA FACULTY OF LAW
APPLICATION FORM
FOR
BACHELOR OF LAWS DEGREE (LL.B)
P. O. Box AH 50, Achimota – Accra, Ghana; Tel: 0302-405805/400457 Ext: 1467/2174
E-mail:
[email protected], Website; www.gimpa.edu.gh
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IMPORTANT: CANDIDATES ARE REQUESTED TO SEND THE COMPLETED FORM TO:
The Senior Assistant Registrar
GIMPA Faculty of Law
P.O. Box AH 50
Achimota – Accra
TO REACH ASSISTANT REGISTRAR WITH THE FOLLOWING ENCLOSURES
(i) Certified true copies of certificates and original transcripts of academic record
(ii) Two recent passport size photographs, one of which should be affixed to the form.
(iii) Two letters of recommendation (use the referee form attached to application form)
(iv) Application fee receipt (Payment of downloaded form should be made either at the following
Banks; Ecobank 0380014426245701 or Consolidated Bank Ghana (CBG) 0510110559613 at
any of their branches in Ghana.
Please note that hand delivery is strongly recommended!
ALSO NOTE: COMPLETE FORMS USING BLOCK LETTERS.
Personal Data
1. Title: …………………………………………………………………………………..
2. Surname::......................................................................................................................
3. Other Names (in full):....................................................................................................
4. Date of Birth:.................................................................................................................
5. Gender: ……………………………………………………………………………….
6. Place of Birth (Region/Country).....................................................................................
7. Nationality:.....................................................................................................................
8. Citizenship: ……………………………………………………………………………
9. Home Language: ……………………………………………………………………..
10. Marital Status:................................................................................................................
11. Last School Leaving year:
Senior High School/ College: MM/YY………… University/Tertiary: MM/YY……..
12. Permanent Address:.............................................................................................................
..............................................................................................................................................
Telephone:..........................................................................................................................
E-mail:.................................................................................................................................
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13. Emergency Contact: ………………………………………………………………………
(The Law School Secretariat must be notified immediately of any change of address)
14. Institutions Attended/Qualification (First Degree and other professional degrees approved
by NAB equivalent to a first degree)
S/No. Institution Index Number Degree/Award Class of Date
Obtained Degree Completed
15. (a) Current employment:......................................................................................................
(b) Town/Region Situated:...................................................................................................
(c) Indicate whether (tick as appropriate) Public Sector (....) Private Sector (...) NGO (...)
16. Please indicate your position in the organization............................................................................
17. Sponsorship (tick as appropriate)
( ) Employer
( ) Self
( ) Other (please specify)
18. Record of key professional experience
Employer Position in Employment Date
i. .............................................. ............................................... ..............................
ii. .............................................. .............................................. ..............................
19. Please give the names and address of one ACADEMIC/PROFESSIONAL referee. References
from personal friends or relatives are not acceptable.
i. Name..................................................................................................................................
Address...............................................................................................................................
Telephone:................................................Fax......................................................................
E-mail..................................................................................................................................
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ii. Name..................................................................................................................................
Address...............................................................................................................................
Telephone:................................................Fax......................................................................
E-mail..................................................................................................................................
20. Declaration
I declare that all the information provided on this form is correct.
Date:............................................. Signature: ........................................................
FOR OFFICE USE ONLY BY ADMISSION OFFICER (ACADEMIC AFFAIRS
DIRECTORATE)
APPLICATION AND ADMISSION STATUS
Application comments, by Admissions Officer Admission Status: Admitted (Yes) or (No)
(Complete) or (not complete)
Application Review Comments: Signature and Stamp of Admission Officer:
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GHANA INSTITUTE OF MANAGEMENT AND PUBLIC ADMINISTRATION (GIMPA)
FACULTY OF LAW
CONFIDENTIAL FORM
I. This section is to be completed by the applicant.
After filling out this section, please give this CONFIDENTIAL Form to your Referee
__________________________________________________________________________________________________
Applicant’s Name
_______________________________________________________________________________________________________________
____________
Applicant’s Address
__________________________________________________________________________________________________
City/Country
__________________________________________________________________________________________________
Date of Birth
__________________________________________________________________________________________________
Telephone Number: Fax Number
__________________________________________________________________________________________________
E-mail:
I hereby authorize the appropriate person to provide the information requested in this document.
Applicant’s Signature: Date:
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II. This section is to be completed by the Referee:
GIMPA would appreciate your assessment of the applicant’s qualities. The Institute will use your appraisal only in
the evaluation of the participant’s admission and its confidentiality will be safeguarded.
Please complete this form as soon as possible and return to: Senior Assistant Registrar
GIMPA Faculty of Law
P.O. Box AH 50
Achimota
Tel.: 0302-405805/400457 Ext. 1467/2174
E-mail: [email protected]
1. General Rating
Please indicate your opinion of this applicant in the context in which you know him or her:
Your assessment should be indicated in each case by ticking of the appropriate check box:
1.1 In your view, how does the applicant rate on the following personal characteristics:
Motivation
Very High ( ) High ( ) Above Average ( ) Average ( ) Below Average ( ) Low ( ) Very Low ( ) Not Known ( )
Self Discipline
Very High ( ) High ( ) Above Average ( ) Average ( ) Below Average ( ) Low ( ) Very Low ( ) Not Known ( )
Leadership
Very High ( ) High ( ) Above Average ( ) Average ( ) Below Average ( ) Low ( ) Very Low ( ) Not Known ( )
Self-Confidence
Very High ( ) High ( ) Above Average ( ) Average ( ) Below Average ( ) Low ( ) Very Low ( ) Not Known ( )
Maturity
Very High ( ) High ( ) Above Average ( ) Average ( ) Below Average ( ) Low ( ) Very Low ( ) Not Known ( )
Academic Ability
Very High ( ) High ( ) Above Average ( ) Average ( ) Below Average ( ) Low ( ) Very Low ( ) Not Known ( )
1.2 Please indicate how well the applicant is known to you:
Known only through Records [ ] Seen Occasionally [ ] Known Personally [ ]
1.3 Please indicate how long you have known the applicant:
Less than 1 year [ ] 1-3 years [ ] More than 3 years [ ]
1.4 The applicant has been known to you as a:
Student [ ] Subordinate [ ] Colleague [ ] Friend [ ] Acquaintance [ ]
2. Specific Comments
2.1 What do you see as the personal strengths of the applicant?
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2.2 In your view, what weakness might the applicant show?
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2.3 GIMPA would appreciate your overall assessment of the applicant’s academic capabilities:
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III. The Referee:
Referee’s Name------------------------------------------------------------------------------------------------------------------------------------
Organization……………………………………………………………………………………………………………………….
Position ………………………………………………………………………………………………………………………….
Address……………………………………………………………………………………………………………………………
E-mail……………………………………………………………………………………………………..
Region/City / Country……………………………………………………………………………………………………………
Contact Phone Number:………………………………………….. Fax Number:…………………………………………..
Referee’s Signature …………………………………………….. Date: …………………………………………………