AGA KHAN UNIVERSITY SCHOOL OF NURSING AND MIDWIFERY, TANZANIA APPLICATION FOR ADMISSION

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Application No. / / / / / / AGA KHAN UNIVERSITY SCHOOL OF NURSING AND MIDWIFERY, TANZANIA APPLICATION FOR ADMISSION POST-RN BACHELOR OF SCIENCE IN NURSING DEGREE PROGRAMME (BSCN) The AKU Post-RN BScN degree is a two and one-half year programme (five semesters) designed to give senior registered nurses the opportunity to upgrade their diplomas to degree level. 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 IV in the Certificate of Secondary Education Examination (CSEE). 2. Five passes at O-level Secondary Education where the passes must include English, Physics, Chemistry and Biology. 3. Diploma in Nursing and Midwifery with a minimum grade of B+ (B plus) or second-class standing awarded by an institution accredited by the National Council of Technical Education (NACTE) or its equivalent. 4. Current licence and registration with either the Tanzania or Zanzibar Nursing Council. 5. At minimum of two years continuous experience in a clinical setting as a registered nurse. 6. Must be a Registered Nurse with a midwifery / psychiatry qualification. 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. Two (2) 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, national ID and Form IV Level 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 Tsh. 10,000 payable when submitting the duly completed application form. 4. Notes Candidates selected for admission to the Post-RN BScN programme will be required to provide original copies of their academic transcripts; Nursing and Midwives Council enrolment certificate and valid nursing licence; and national ID card 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 Form IV level certificate. Copies of academic certificates & transcript from your nursing training institution. Copies of your Nurses and Midwives Council registration certificate and valid license. Current curriculum vitae. Copy of your national ID. Recommendation form from your employer with official stamp in a sealed envelope. Two 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 344, Salama House On Urambo Road, Off United Nations Road P.O. Box 38129 Dar es Salaam, Tanzania Tel: +255 222 122 740 Fax: +255 222 122 764 Email: regoff.tz.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.

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 Post-RN BScN Application Page 3 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 Post-RN BScN Application Page 4 of 5

2017 Post-RN BScN Application Page 5 of 5