Khartoum International Academy of Journalism  

Career Training Centre  
Application Form for Short Certificate Courses        

SRN
 

                           1-5. Personal details (PLEASE WRITE CLEARLY IN BLOCK CAPITALS)
             
Surname/family name
           First/given name(s)   
 

                            Record your names below IN THE ORDER in which you wish them
                 to appear on the Academy’s records and on your final certificate.
           Title  MrMrsMsOthers
           Date of birth 
           SEX    Male        Female

                                Home address (PLEASE WRITE IN BLOCK CAPITALS)
                             
              Country
              Telephone number

 

E-Mail

Courese

 

Course for which you are applying

 

                Declarations to be signed by the applicant (Please read carefully before signing)

a)      I declare that the statements made by me on this form are, to the best of my knowledge and belief, true and correct.

b)      I agree to the Khartoum International Academy of Journalism-University of London External Programme Tuition Centre (Sudan) processing my personal data contained in this form and other personal data that the Academy may obtain from me or from other people connected with my studies. I agree to the retention and disclosure of such data for normal academic and administrative purposes in accordance with the principles set out in the 1998 Data Protection Act.

c)      I agree to the fact that fees paid by me to the Academy on no account and under any circumstances can be refunded, whether prior to the commencement of my studies or at any stage of my studies.

d)      I agree to the fact that despite delays in completion of study groups (Minimum being 15) I will wait for any length of time for my group to complete before commencing studies.

e)      I agree to the fact that I will be in constant contact with the Academy to verify the starting date of my course and that the Academy does not bear any liability for failure to contact me prior to the commencement of my course.

f)       I agree to the fact that my personal belongings (Including money, mobile phone, jewellery etc.,) brought to the Academy are at my own risk and that the Academy bears no liability for any misplaced or stolen personal items. However the Academy’s Security Department will carry out thorough indoor investigations where cases of pilfering or theft occur within its premises.

Signature (Name) _____________________________       Date___________________

Please do not fill in anything below this line – for office use only
 

EXEMPTIONS

A.   Application made __________________

B.   Decision ( as appropriate) _____________________

·        Request not valid, cannot be considered ____________

·        Exemption given (for the subject/s listed below) __________________

·        First check _______________

·        Second check ____________________

Fee paid ________________   Type of payment _____________________     

Date received _______________

Method of payment _____________

Referral details and decision ________________________

Copyright © 2001 - 2002  KIAJ .
By : Haj Network Solutions