UNIVERSITY OF PRETORIA
FACULTY OF HEALTH SCIENCES
APPLICATION FOR SELECTION TO CONTINUE POST GRADUATE STUDIES
AS A REGISTERED STUDENT
Year of intended study
PLEASE HAND IN YOUR APPLICATION AT THE RELEVANT DEPARTMENT
Student number
Surname
Full name
ID number
Permanent
postal address
Code
Telephone
Cell phone
E-mail
Pre-graduate
study course
Post-graduate
study course
Signature
Date
OFFICIAL USE ONLY
Recommended
Date
HEAD OF DEPARTMENT
Approved
Date
DEAN
Conditions:
Curriculum Vitae, Written declaration of intention, Motivation/support from employer
0