MINISTRY OF TERTIARY EDUCATION, REASERCH, SCIENCE &
TECHNOLOGY
SEROWE COLLEGE OF EDUCATION
APPLICATION FOR DIPLOMA IN PRIMARY EDUCATION COURSE (DPE)
Please send the completed application form and supporting documents to:
Principal
Serowe College of Education
Private Bag 009
Serowe
Application Number: Deadline for submitting this form:
COMPLETE ALL SECTIONS (A–L). FAILURE TO DO SO WILL DELAY OR DISQUALIFY
YOU
A. Applicant’s Surname:------------------------------------------- Other names:
…………………..................................
Permanent Address:…………………………………………………….....
Tel No /Cell No:…………….............................
Address for reply to this application:
…………………………………………………………………………………......................................................
..............
Full date of birth:…………………….. .. Place of birth:……………… .. District of origin:
………........................
Gender::…………. Nationality:……………………………
National Registration No.:………………………....... Passport No (for Non citizens only):
-----------------------
Marital Status (Married or Single): -----------------------------
B. Name of last Secondary School attended:…………………………………Years from …….... to
……........
Completion year for Cambridge/GCE/BGCSE:………………….…………………… Result (circle):
1st/2nd/3rd/GCE class pass or ------------- points (best 6)
Name of last Tertiary Institution Attended: ------------------------------------------------------
Course Pursued:-------------------------------- Year of Completion: ------------------
If not completed why? -------------------------------------------------------------------------
C. Do you have any teaching experience? ……………… If Yes, number of years experience:
………… years
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Tick type of school : Gov. ( )/ Private ( ), Primary ( ); Junior Secondary ( ) ,Senior
Secondary ( ) ,
TSM No. (if applicable): …………......
Name, address and district of the school at which you are presently teaching or where you
were last teaching:
………………………………………………………………………………………………………………………………
D. Other education, experience or employment – state name and address of all your
employers, courses attended and nature of work in any job(s). State how many months you
worked in each job.
………………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………
What work or study are you doing this year?
…………………………………………………………………………………………............................................
............
E. I would like to SPECIALIZE in the following TWO subjects: (see ATTACHED INFORMATION for
possible combinations):
First Choice: …………………………………...... and
…………………………………………............
Second Choice: …………………………………… and
……………………………………....................
Third Choice: …………………………………… and ………………………………………………....
F. Sponsorship History
(i) Have you ever been sponsored by Botswana Government in a tertiary institution before?
Yes or No _____________
If yes, provide the following information:
(ii) Name of the institution you were sponsored for._______________________________________
(iii) Programme/course sponsored. ___________________________________
(iv) Year of completion. ________________
(v) If not completed, state why. ________________________________________________
(vi) Any other information?
_________________________________________________________________________________________
G. Sponsorship: Who is responsible for sponsoring your training? (Please tick the appropriate)
(i) …..….. Botswana Government
(ii) ………. Parent/Guardian/Self
(iii) ……… Employer/Company
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Please give the name of the sponsor if the sponsor is NOT Botswana
Government:--------------------------------
H. Social Needs and Disability
(i) Do you have any form of disability? Yes or No __________________
(ii) If yes, what disability? ______________
(iii) Are you under any social welfare programme? Yes or No. __________
NB: If yes, attach supporting documents.
_______________________________________________________________________________________________
I. Name and address of next of kin (This must be the person you would like us to contact in
case of emergency and who has agreed to support you morally and fnancially, if you are
admitted to College).
Surname: …………………………….…………………...... Other names:……………..
…………………….......
Relationship to applicant: …………………………............ Address:
………………………………………….........
Contact Phone / Cell No: …………………………………………
J. Referee: Give the name of the person in a responsible position who has agreed to write a
testimonial on your behalf.
Name: Mr/Mrs/Miss…………………………………......................
Address:………………………………………………………
Position: ……………………………………………….....
K. Declaration by Applicant – The above statements are true to the best of my knowledge
and if my application is accepted, I will abide by ALL COLLEGE REGULATIONS. I furthermore
understand that giving false information on this application is an ofence punishable by law and
may result in my withdrawal from the selection process or from the college Training
Programme. I further understand that admission to this programme of study is conditional upon
securing sponsorship.
Signature: ------------------------------------ Date:
------------------------------------
L. Declaration by Parent/Guardian or any custodian
I, the undersigned, agree to this application made by my
son/daughter/dependent/husband/wife (tick).
Name (in BLOCK letters) Mr/Mrs/Ms …………………………………… Signature:
…………………………
Address (in BLOCK letters) ……………………………………………….... Date:
……………………………........
In case you have NOT attached certifed copies of your academic result slip (O-level
/COSC, BGCSE or equivalent), certifed omang copy together with at least 2 references
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when submitting your application, you MUST send them to us or bring them along with this
application form.
___________________________________________________________________________________________
DO NOT WRITE IN THIS SPACE (for Ofce use only):
Admitted: ---------------- Not Admitted: ---------------
Comment: (if any) :
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Signature: --------------------------------- Date: --------------------------------------
