POSTAL AND TELECOMMUNICATIONS REGULATORY AUTHORITY OF ZIMBABWE AND
HARARE INSTITUTE OF TECHNOLOGY
DATA PROTECTION OFFICER TRAINING ADMISSION APPLICATION FORM
YEAR
SECTION 1
1. PERSONAL DATA
1.1 SURNAME:
1.2 TITLE: e.g Mr/Mrs/Miss/Dr/Ms/Rev/Sr
1.3 FORENAMES:
(As on birth certificate)
1.4 PREVIOUS SURNAME:
1.5 SEX: Male (M), Female (F)
1.7 NATIONALITY: ……………………………………………………………
1.8 CITIZENSHIP: ……………………………………………………………...
1.9 ARE YOU A PERMANENT RESIDENT OF ZIMBABWE? Yes (Y), No (N)
IF NOT: What permit do you hold? …………………………………………
PERIOD OF RESIDENCE IN ZIMBABWE: ……………..…………………
1.10 DATE OF BIRTH: e.g. Day (15) Month (04) Year (2008) ………………………………………………………………
1.12 DO YOU SUFFER FROM ANY PHYSICAL OR OTHER DISABILITIES FOR WHICH ARRANGEMENTS AT
INSTITUTE WOULD BE NECESSARY? YES (Y), NO (N)
IF YES PLEASE GIVE DETAILS ………………………………………………….……………………………….
1.13 NATIONAL I.D NO.: ……………..………………………….. PASSPORT NO.: …………………………
2. ADDRESS (PERMANENT)
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3. TELEPHONE NUMBERS
Cell Phone:……….………………………………………. Home:……………………………………………………
E-Mail:……………………………………………………. Office or other contact number: .………………………
4. NEXT OF KIN
Name and Surname……………..………………………. Contact mobile number:………………………………
Email Address of next of kin ……………………………….………………………………………………………….
SECTION 2
5. ENTRY REQUIREMENTS
Normal Entry –
For normal entry candidates should:-
a) Candidates must have a minimum of a first degree (or equivalent).
b) Have passed English Language and Mathematics at Ordinary Level or approved equivalents.
Special Entry –
a) A minimum of 5 O level passes including English.
b) 2 A level passes with at least 2 years of working experience in a relevant field. Or a National Diploma with a minimum
of 2 years of working experience in a relevant field.
International Entry –
This admission is considered through non- Zimbabwean Qualifications.
The following are acceptable to the Institute:-
Ordinary Level Pass or Equivalent
Zimbabwe Schools Examinations Council (ZIMSEC) Certificate, Higher Education Examinations Council (HEXCO) Certificate,
Ordinary Level of the Associated Examining Board’s General Certificate of Education; Credit Standard of Cambridge Overseas Higher
School Certificate; Ordinary Level of the University of London’s General Certificate of Education and Advanced Standard of the
Cambridge Overseas Higher School Certificate.
6. TYPE OF ENTRY (ADMISSION)
Indicate the type of entry (admission) preferred with a tick in the relevant box below.
Normal Entry
Special Entry
International Entry
7. SCHOOL EXAMINATIONS FOR WHICH RESULTS ARE KNOWN
Attach your certified copies of O-Level, A-Level or equivalent.
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8. TECHNICAL/POLYTECHNIC COLLEGE EXAMINATIONS FOR RESULTS WHICH ARE KNOWN
DIPLOMA QUALIFICATION COMPLETED: Yes (Y) No (N)
Attach your certified copies of Diploma Transcript or equivalent
9. UNIVERSITY ATTENDED
Have you ever attended any other universities? Yes (Y) / No (N) If yes: Name
and Address of University attended
………………………………………………………………………………………………………………………….
…………………………………………………………………………..……………………………………………..
PERIOD OF ATTENDANCE: Starting Year (e.g. 1996)
Ending Year (e.g. 1999
PROGRAMME OF STUDY……………………………………………………………………………………………
……………………………………………………………………………………………….………………………….
……………………………………………………………………………………………….…………………………
QUALIFICATION COMPLETED: Yes (Y) No (N)
10. OTHER RELEVANT INFORMATION/REMARKS
10.1 WORK EXPERIENCE/EMPLOYMENT
DATE OCCUPATION NAME AND ADDRESS OF EMPLOYER
FROM TO
MONTH YEAR MONTH YEAR
11. PROSPECTIVE SPONSORS ………………………………………………………………………………………………………………
(e.g. self, Government or other organization)
12. Notes to all applicants
12.1 Applicants must complete all sections of the application form carefully and legibly. If the Institute discovers that any
information submitted by the applicant is false, the Institute will reject that application and may refer the matter for legal
action.
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12.2 Applicants must endorse at the bottom of this page that they have understood the notes given below and that they agree to
their application being considered under the conditions outlined below.
12.3 Applicants MUST submit with this form, photocopies (not originals) of all qualifications/certificates referred to in the
application, including birth certificates. The copies of the certificates must be verified by a Commissioner of Oaths or
Head/Principal of the Institute at which the examinations were taken.
12.4 Finance
12.4.1 Applicants must ensure that they have the necessary finance to pay on registration. It is the student’s responsibility
to secure sponsorship, if this is needed.
13. I DECLARE THAT THE INFORMATION I HAVE GIVEN IS CORRECT, AND THAT SHOULD IT BE FOUND TO BE
FALSE MY APPLICATION WILL BE DISQUALIFIED AND I WILL FACE POSSIBLE LEGAL ACTION.
N.B: BEFORE YOU SIGN AND DATE THIS FORM, PLEASE CHECK THAT YOU HAVE COMPLETED EACH RELEVANT
SECTION AND THAT THE INFORMATION IS CORRECT.
SIGNATURE OF APPLICANT: ……………………..………………. DATE: …………………………….………
The completed form should be accompanied with certified copies of the following:
(a) Relevant academic and or professional certificates, results slips or transcript
(b) National Identity Card or page/s with personal details of the candidate’s passport
(c) Birth Certificate
(d) Proof of paid application fee
SECTION 3
FOR OFFICIAL USE ONLY
CERTIFICATES RECEIVED/VERIFIED
Birth / nation ID Receipt
ND Acknowledge
HND Prev
Ref Asked
‘O’ Level School
‘A’ Level College
School Other
University
App No.
Normal
Special
