Shalome Skills Training Centre
ZANIMOUNE ALONG GREAT NORTH Road Lusaka Main Campus
F Mobile: 0961312658
P.O. Box 36569, Lusaka, Zambia EMail:officeadmission44@gmail.com
0961312658 Lusaka Campus
STUDENT APPLICATION FORM
Read the application instructions before filling in your personal details.
(Complete all appropriate sections below)
Part C
EMPLOYMENT INFORMATION IF APPLICABLE
NAME OF COMPANY
POSITION
ADDRESS
E-Mail: WhatsApp No.
Part E
Have you previously applied to College?
YES NO
If yes ,which year and semester Year Semester
!APPLIC!NT’S !CCOMMOD!TION STATUS: I PLAN TO RESIDE:
ON CAMPUS BOARDING DAY SCHOLAR OTHER
If you decide to live on campus apply for accommodation and confirm availability of
space prior to Making Payment
D
EDUCATIONAL BACKGROUND
Highest Educational Standard Attained: Number of Subjects Obtained at Credit Level or Better
Please list below, all schools and colleges you have attended and attach an extra
informative paper if necessary
Academic Primary/Secondary School No of Study Area Certificate
Years Attended Years Major/Minor Or Degree Obtained
(From- To) Spent
E
GUARDIAN/SPONSORS DETAIL
Name: Occupation:
Address: Phone/Cell Number:
Indicate the source of financing for intended training:
Employer--------------------------------------Self--------------------------Others--------------------------------------------------------------
G
SOURCE OF INFORMATION ABOUT THE COLLEGE H
SELECTION OF CANDIDATES
Only the best five (5) subjects will be considered- one from each of the five categories below
CATEGORY SUBJECT GRADE CATEGORY SUBJECT GRADE
English Language Commerce
A English Literature Environmental Science
Advanced Mathematics Geography
B Mathematics Human Biology
Chemistry E Metal Work
C Physics
Nutrition
Science (Combined)
Principles of Accounts
D Biology
Technical Drawing
This APPLICABLE TO MEDICAL STUDENTS ONLY)
I
OTHER TERTIARY QUALIFICATIONS ALREADY OBTAINED IF ANY
OTHER QUALIFICATIONS INSTITUTION DURATION CLASS
E.g. Certificate in Marketing Coop College -Lusaka 2 Years Merit
1
2
PART E: CATEGORY OF APPLICANT (Tick whichever is applicable to you)
(a) I am a school leaver (if you completed Grade 12 in 2017 or
2018
(b) I am a non-school leaver (if you completed Grade 12 before 2016)
J
DECLARATION BY APPLICANT:
1. I…………………………………………………………………………hereby declare that I have read and understood all
conditions and terms of this contract and hereby certify that the information I have given in this
application is complete and accurate to the best of my knowledge. That all documents supplied with
this Application are legally obtained, and that submission of fabricated or fraudulent documents and
information will warrant immediate dismissal and liable to litigation.
2. I also certify that I have understood all rules and regulations laid down by the College and agree
that any miss presentation or omissions of facts may justify the denial, expulsion or
Cancellation of my studentship
3. Payments of School Fees and other Requirements to be paid upon opening
4 I understand that fees paid are nonrefundable under any circumstances whatsoever. In case I am not in
a position to join or continue the course even after submission of my tuition fees, I will not claim refund
of any fees paid. I also understand that this study contract is binding to college regulations. I further
declare that I will meet my tuition fees and all other fee associated with my studies at LUSCA
5 I undertake to abide by all regulations that the college may introduce from time to time in an effort to
harmonies the learning process for the benefit of both parties, the college and students
6 I further declare that am agreeable to receiving new rules and regulations during duration of my course
7. Pleas note that application fees are non refundable once paid.
NB: a. Ensure to attach photocopies of your Grade 12 school certificate, results or the equivalent of GCE
“O” Levels, Copy of the National Registration Card (NRC) as well copies of other tertiary certificates already
obtainedif any.
b.Ensure you provide current address and work details, your mobile phones and E-mail addresses may
be used to contact you: if these details happen to change, after you havesubmitted this application form,
ensure that you notify the college of changes as soon possible to avoid losing your mail
c. Return the dully filled in application form addressed to the “Principal,” via electronic mail or in person.
(Your application cannot be considered in absence of this proof of payment)
Signature ---------------------------------------------------------------Date------------------------------------------------------
