Application for admission to graduate study (regular programs)

Application for admission to graduate study

(regular programs)

INSTRUCTIONS

1. For clarity, please USE CAPITAL LETTERS TO FILL OUT THIS FORM.
2. Complete this Application form in THREE COPIES.
3. Submit the Following Documents along with the Completed Application Form.
4. a) TWO COPIES of the official Transcript of Academic record of the bachelor’s and Master’s Degree for Master and PhD program, respectively
5. b) AN AUTHENTICATED PHOTOCOPY of your diploma
6. c) First Degree holders from Universities other than Haramaya University must present a copy of results of GCE or West African Schools Certificate of Oxford Examination or any other accredited High School Examination Result Paper.
7. d) A Bank Receipt of 200 Birr for Application Fee, deposited to Commercial Bank of Ethiopia, Haramaya University Account Number 1000093271557
8. NOTE: Applications must be submitted to the address below, not later than three Months before the scheduled date of enrollment.

HARAMAYA UNIVERSITY

OFFICE OF THE REGISTRAR

P.O. BOX 138

DIRE DAWA

ETHIOPIA

FAX 0255530325

1. The enclosed recommendation letters should preferably be mailed earlier directly by your referees to the address above.
2. PERSONAL DTAILS

________________________         ______________________          __________________

Name                                                 Father’s Name                       Grandfather’s Name

Present address ___________________________________________________________

Region/Administrative Council ____________________ Town/City ________________

P.O. Box _________________ Country ______________________ (for foreigners)

Tel. _______________ Fax ________________ e – mail _________________________

Home Address ___________________________________________________________

Region/Administrative Council ____________________ Town/City ________________

P.O. Box _________________ Country ______________________ (for foreigners)

Tel. _______________ Fax ________________ e – mail _________________________

Date of Birth: Date __________ Month ______________ Year ________ (European Calendar)

Place of Birth _______________________                                 _______________________

Town/City          Region/Province/Country

Sex:           Male              Female (put “X” mark)

Marital Status:         Single            Married             Divorced

Number of Children or Dependents ____________________________________________

Mother’s Full Name ________________________________________________________

Name of person to be contacted in case of emergency ____________________________

Address ________________________________________________________________

Province/Region ___________________ Town/City _____________________________

P.O. Box _____________ Country ____________________ (for foreigners)

Tel. __________________ Fax ____________________ e – mail __________________

1. EDUCATIONAL QUALIFICATIONS

First Degree            Second Degree             Third Degree (put “X” mark

 III. WORK EXPERIENCE

State your present work ____________________________________________________

Give the address of your present employer _____________________________________

Province/Region ______________________ Town/City __________________________

P.O.Box _______________________ Country _____________________ (for foreigners)

Tel. _____________________ Fax ___________________ e-mail __________________

1. RESEARCH

Give particulars on any relevant experiences you have. Give reference you have. Give

References to any published work you have done. Enclose copies if possible.

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

1. REFERENCE

Give names and addresses of three persons, preferably postgraduate instructors, employers and professional associates, to whom reference can be made about your Ability. Specify your association with each referee. Have each one fill out the enclosed recommendation form.

1. _________________________________________________________
2. _________________________________________________________
3. _________________________________________________________
4. FINANCIAL SUPPORT

Give the name and address of the sponsoring organization of your graduate study. The Sponsorship form should be completed and duly signed by your sponsor and submitted to the Office of the Registrar with your application form. Please be informed that the Sponsorship must include research expenses (A separate form is enclosed).