Application No. / / / / / / AGA KHAN UNIVERSITY SCHOOL OF NURSING AND MIDWIFERY, UGANDA APPLICATION FOR ADMISSION DIPLOMA IN GENERAL NURSING The AKU Diploma in General Nursing is a two-year programme (four semesters) designed for enrolled nurses (EN s), Enrolled Comprehensive Nurses (ECNs), Registered Midwives and Registered Psychiatric Nurses (RPNs) who wish to upgrade to General Nursing Diploma and licensed to practice as Registered Nurses. ADMISSION CRITERIA Candidates for admission are required to meet the following minimum requirements: 1. Form IV level of education with a minimum aggregate of Division III in the Ordinary Certificate of Education. 2. Pass grade in the following subjects: English, Mathematics, Physics, Chemistry and Biology. 3. Certificate of enrolment from the Uganda Nurses and Midwives Council. 4. Certificate of registration from Uganda Nurses and Midwives Council. 5. At minimum of two years continuous experience in a clinical setting as an enrolled nurse. INSTRUCTION FOR COMPLETING THE APPLICATION Please ensure that you have enclosed the following in making your application to the Aga Khan University, School of Nursing and Midwifery (see page 2 for a check list): 1. Application Form Complete in all respects as instructed. Three (3) recent passport size photographs labelled with your name and stapled as required. 2. Required Documents (to be attached to the Application Form) Current Curriculum Vitae Copy of academic transcripts from your nurse training institution. Copies of your enrolment certificate and nursing license from the Nurses and Midwives Council, birth certificate/national identity card/passport and UCE / UACE certificate. A recommendation form from your employer to be sent directly to the Aga Khan University, School of Nursing and Midwifery. 3. Application Fee A non-refundable application fee of Ush. 30,000 payable in cash when submitting the duly completed application form. 4. Notes Candidates selected for admission to the Diploma in General Nursing programme will be required to provide original copies of their academic transcripts; Nurses and Midwives Council enrolment certificate and valid nursing licence; and birth certificate/national identity card/passport for verification by the Registrar s Office. Submitting false information or academic credentials when applying for admission to the University or for any of its programmes and services and will automatically result in disqualification of your application from the University or its programmes.
CHECKLIST All of the following documents must be submitted in the application package. Partial applications are not accepted and an application will not be considered complete until all the documents are received: Completed Application Form. Copy of your UCE / UACE certificate. Copies of academic transcript from your nursing training institution. If a copy of the transcript is not available, you must present a certified letter from you training institution. Copies of your Nurses and Midwives Council registration certificate and valid license. Current curriculum vitae. Copy of your birth certificate / National Identity Card / Passport. Recommendation letter / form from your employer with official stamp in a sealed envelope. Three (3) recent coloured passport-sized photographs labelled with your name. One-page word-processed personal statement describing your professional goals for the next five years. RETURN APPLICATION TO: Registrar s Office Aga Khan University School of Nursing and Midwifery Plot 9/11 Muammar Gaddafi Road P.O. Box 8842 Kampala, Uganda Tel: +256 414 349 494 Email: regoff.ug.sonam@aku.edu If delivered by hand, applications will be received Monday - Friday, 9.00 am to 12.00 noon. Last date for receiving applications is March 31, 2017 Late applications will not be accepted.
Page 3 of 5 AGA KHAN UNIVERSITY SCHOOL OF NURSING AND MIDWIFERY APPLICATION FOR ADMISSION 1. Please read and complete all items on the form very carefully. 2. Use BLOCK LETTERS to complete the application. 3. Tick only within the appropriate boxes. 4. When completed, please deliver the form to the Office of the Registrar. Please affix recent passport size coloured photograph here. 1. NAME First Name Middle Name Last Name 2. GENDER 3. MARITAL STATUS (CHECK ONE) Male / Female / Single / Married / Other / 4. DATE OF BIRTH 5. CITIZENSHIP Day / Month / Year / 6. MAILING ADDRESS Address Postal Code City District Mobile Number Email Address 7. WORK INFORMATION Name of Institution Current Position Address Postal Code City District Mobile Number Email Address 2017 EN RN Application
Page 4 of 5 8. ACADEMIC QUALIFICATIONS (SECONDARY AND POST-SECONDARY EDUCATION) Degree / Certificate Year Institution 9. OTHER QUALIFICATIONS (IF APPLICABLE) Diploma / Certificate Year Institution 10. EMPLOYMENT HISTORY From To Institution Designation NOTE Aga Khan University reserves the right to revoke admission and registration if an application form is discovered to be inaccurate or incomplete, or if supporting documents are discovered to be fraudulent. Any applicant who presents a fraudulent document in support of an application for admission may be identified to other universities and colleges. DECLARATION The information that I have provided is correct. I agree to conform to the selection process and to accept the decision of the School of Nursing and Midwifery concerning the evaluation of my application and the final selection. If I am selected for admission, I will abide by the rules, regulations and policies of Aga Khan University as they may be at the times of admission or as they may be changed during my continuance as a student. Print Name Date Signature 2017 EN RN Application
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