u of lusaka clearance form

CLEARANCE FORMOffice Of Registrar | P.O.Box 36711 Lusaka, Zambia | +260 976075850 / +260 953688533 | +260976200094

Academic@unilus.ac.zm | registrar@unilus.ac.zm | mchanda@unilus.ac.zm

U n i v e r s i t y o f L U s a k a

(1) STUDENT INFORMATION

Names (Mr/Mrs/Ms/Dr):_________________________________________________________________

Student No:____________________________________Cell____________________________________

Email:________________________________________________________________________________

Reason for clearance (Tick):

Withdrawing Transferring

Graduation CertificateCollection

APPROVED BY :_______________________________________________________________________

SCHOOL HOD: I__________________________________________________certify that the student has

cleared and submitted the dissertation as required by the University. SIGNATURE____________________

LIBRARIAN: I____________________________________________________ certify that the above

student has returned all material to the University. SIGNATURE____________________

ACCOUNTANT: I__________________________________________________ ceritify that the student

does not owe the Unversity any fees. SIGNATURE____________________

ACADEMIC OFFICES: I________________________________________________certify that the

above student has satisfied all the above requirements and has returned the student identity card to the

University. SIGNATURE____________________

(2) OFFICIAL USE ONLY

DATE STAMP