The document is an application form for graduate studies at the University of Dodoma. It requests personal information from the applicant, their educational background and qualifications, employment history, references, and information on how application fees will be paid. The applicant must submit the completed form along with academic certificates and proof of application fee payment by the deadline to the Admission Office at the University of Dodoma for consideration.

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THE UNIVERSITY OF DODOMA
APPLICATION FOR ADMISSION TO GRADUATE STUDIES
ACADEMIC YEAR 2014/15
_______________________________
PLEASE READ CAREFULLY BEFORE FILLING IN THE FORM
PROGRAMME:
Please indicate which programme module you are applying for:
(Tick the appropriate box)
Degree Programme Applied for. Please write the code appropriately as shown below:
01 Postgraduate Diploma in Education (PGDE)
02 Full- time Master of Arts in Education (MA. Education)
03 Evening Master of Arts in Education (MA. Education)
04 Full-time MBA
05 Evening MBA
06 Executive MBA
07 Full-time Master in Public Administration (MPA)
08 Evening Master in Public Administration (MPA)
09 Master in International Relations (MIR)
10 Full-time Master in Development Studies (MA DS)
11 Evening Master in Development Studies (MA DS)
12 Master of Arts in Sociology (MA Sociology)
13 Master of Science in Natural Resources Management (MSc. NRM)
14 Master of Arts in Demography (MA Demography)
15 Master of Arts by thesis in Kiswahili
16 Master of Arts by thesis in History
17 Master of Arts by thesis in English
18 Full-time Master of Arts in Linguistics (MA Linguistics)
19 Master of Arts in Kiswahili Literature (MA Kiswahili Literature)
20 MA in Theatre and Film for Development by thesis
21 Fulltime Master of Science in Computer Science (MSc. CS)
22 Evening Master of Science in Computer Science (MSc. CS)
23 Executive Master of Science in Computer Science (MSc. CS)
24 Fulltime Master of Science in Telecommunication Engineering (MSc. TE)
25 Evening Master of Science in Telecommunication Engineering (MSc. TE)
26 Executive Master of Science in Telecommunication Engineering (MSc. TE)
27 Fulltime Master of Science in Information Technology (MSc. IT)
28 Evening Master of Science in Information Technology (MSc. IT)
29 Fulltime Master of Science in Information Systems (MSc. IS)
30 Master of Science in Biodiversity Conservation (MSc BC)
31 Master of Science in Mathematics (MSc Mathematics)
32 Master of Science in Nursing – Mental Health (MSc Nursing - Mental Health)
33 Master of Medicine in Surgery
34 Master of Medicine in Internal Medicine
35 Master of Medicine in Obstetrics and Gynaecology
36 Master of Medicine in Microbiology and Immunology
1.0 PERSONAL INFORMATION
1.1 Surname (IN BLOCK LETTERS)……………….
First name …………...……………….Middle Names………………………………….…
1.2 Sex (Tick the appropriate box) Male Female
1.3 Date and Place of Birth: Date………………. Place of birth………….……..…
1.4 Citizenship ………………………………...1.5 Religion…………………………………………
1.6 Marital status: (Tick the appropriate box) Single Married Widow Divorced
1.7 Passport No. (Non-Tanzanian): ………………….Place of issue……………………………………………..
Date of issue………………………………………..Date of expiry ……………………… ……………….…..
1.8 Mailing (Home) Address: ………… ……….……………………………………………………….…………..…
1.9 Work Address……………………………………………………………………………………………………….
Fix your passport size
photograph here
For Official Use Only
Ref. No:

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1.10 Tel. Number ………………………..…… ………...1.11 email……… ……… …………………….…..…
1.12 Any disability? None Physical Visual Hearing Speech
(Please note that this information is only required for the University to assist you once you are admitted)
1.13 Name and address of next of kin (state relationship):
…………………………………………………………………………………………………………………................................
..........................................................................................................................................................................................
2.0 EDUCATIONAL QUALIFICATIONS
2.1 Please list degrees or diplomas in the table given below.
S/No. University/College/Equivalent
Institution
Dates of
Attendance
Qualification
Awarded
Class of
degree
Date of
Award
Subjects
Studied
2.2 Professional qualification……………………………………………………………………………………………..
Institute…………………………………………………………………………………………………………………
3.0 EMPLOYMENT RECORD
Provide details of your career to date, starting with the most recent. Duration of work experience: …….years.
Dates Name of Company/Institution
address
Job title or
responsibility
Any Remarks
4.0 REFERENCES
4.1 Please indicate the names and addresses of THREE people who can comment on your suitability for the
degree programme you are applying for. Reference letters should only be written by people who have
supervised you in your academic studies or at work. Letters from families and friends will not be accepted.
Referee No. 1
Name……………………………………………………………………………………………………………………….
Address……………………………………………………………………………………………………………………
Telephone………………………Fax…………………………Email……………………………………………………
Referee No. 2
Name……………………………………………………………………………………………………………………….
Address……………………………………………………………………………………………………………………
Telephone………………………Fax…………………………Email……………………………………………………
Referee No. 3
Name……………………………………………………………………………………………………………………….
Address……………………………………………………………………………………………………………………
Telephone………………………Fax…………………………Email……………………………………………………
4.2 Ensure that referees send their references on time for the application to be considered. They must comment,
but not restricted to the following attributes:
• Academic ability
• Capacity to think logically
• Communication skills
• Ability to work hard and independently
• Ability to meet deadlines
• Leadership skills
• Capacity to interact with others

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5.0 FINANCIAL ARRANGEMENT
Please indicate the source of your financial support………………………………………………………………….
………………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………
6.0 SUBMISSION REQUIREMENTS
This application form has to be fully completed and attached with the following documents:-
(a) Copies of education certificates
(b) Bank pay-in slip of a non-refundable application fee of TSh 45,000/= for a Tanzanian OR US $
45.00 for a non-Tanzanian. The application fee must be paid to:
The University of Dodoma; CRDB Bank Ltd; Account Number 01J1082491700.
Note: The pay-in slip must indicate your name as it appears in this application form.
7.0 DECLARATION
I declare that I have personally filled in this form and the information contained herein is complete and
correct.
I shall not involve myself in any misconduct that may tarnish the image of the University of Dodoma if am
admitted
Signature of Applicant………………………………………..Date………………………………
8.0 SUBMISSION
All applications must be submitted by post or by hand to the following address:
Admission Office, Office of the Deputy Vice Chancellor (Academic, Research and Consultancy)
The University of Dodoma, P.O. Box 259, Dodoma, Tanzania, Tel: +255 (0) 262310173
(Please DO NOT SEND BY FAX)
9.0 FOR OFFICIAL USE ONLY:
Date received: …………………The Application is complete The Application is incomplete
(Indicate what is missing)………………………………………………………………………………………………
Name of Officer………………………………………………….Signature……..……………………………………