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NAMCOLNamibian College of Open Learning
APPLICATION FORM FOR TVET PROGRAMS 2016
LEARNER SUPPORT SERVICES Private Bag 15008, Katutura, Republic of Namibia
Telephone: +264 (61) 320 5111Fax: 264 (61) 216 987
Automotive Mechanics
Plumbing and Pipefitting
Welding and Metal Fabrication
Student No:
Title:
Surname :
First Names:
Date of Birth :
ID Number:
Male Female
Do you have a disability? Yes No (information required for planning purposes only)
If “Yes” please specify: .......................................................................................................................
Postal Address: Street Address:
P.O. Box ..…………………….......……….......… Street ………………............................................…
Private Bag …………………………................... Erf No. ...........................................………………...
Name of Post Office …………………................ Village/Town/City …................................………….
Telephone Numbers:
At work: code: ………....... Tel: ……………..................... Fax: ……...….….......…...............
At home: code: ……....…... Tel: ………………................. Cell: ..........……….......……........
E-mail: .....................................................................................................................................
Name of Employer: ……….............................................................................…………………………
Position held: ……...........................................................................................................…………….
Guardian's Name: ..............................................................................................................................
Guardian's Contact Detail: .................................................................................................................
Tick (√) in the box next to the programme you would like to apply for:
NB. Only at Yetu Yama Centre, Katutura
(For office use only)
Y Y Y Y - M M - D D(year-month-day)
Yetu Yama Centre
Otjiwarongo Centre
Ongwediva Centre
Rundu Centre
Trade: OfficeAdministration:
MotherTongues:
AcademicQualification:Institution Certificateobtained Year
Experienceinrelatedfieldofwork:Position Institution Year (eg. 1990-2013) Responsibilities
Why do you want to enrol for this programme?
………………………………………………………………………………………………….....……………
……………………………………………………………………………………………………….....………
……………………………………………………………………………………………………….....………
…………………………………………………………………………………………………….....…………
I understand that completion of this form does not necessarily mean automatic acceptance into the training programme requested. I agree to make myself available for the aptitude testing and interview. I further acknowledge that if accepted into a training programme, I will sign the Trainee’s Code of Conduct agreeing to abide by the Training Centre’s Rules and Regulations.
Applicant’s Signature: ………………………………………. Date: …...........…….........................…….
Signature of Guardian (if under the age of 18): ..................................................................................
NB!!Attachallcertifiedcopiesofqualifications,identificationdocuments,workexperience(e.g.testimonialletters)andyourpassportphoto.
Result Interview Result FinalCHECKLIST:
Reject / Accept for Aptitude Testing of Aptitute Test Date of Interview Decision
Initials of Evaluator: ....................... ............... ............... ................... ..............
Afrikaans
English
German
Ju!'hoansi
Khoekhoegowab
Oshikwanyama
Oshindonga
Ojtiherero
Rukwangali
Rumanyo
Setswana
Silozi
Timbukushu
Other:....................................
Enclose a cheque or copy of receipt of N$50 for processing fees.
Include all required paper work
Completed application form