AYER TENA HEALTH SICENCE AND BUSINESS COLLEGE
OFFICE OF THE REGISTRAR
STUDENT ADMISSION FORMFOR DEGREE PROGRAM 2023 ENTERY
INSTRUCTIONS
The applicant should fill this application form in duplicate.
1. Write legibly and complete the form correctly and accurately
2. When the answer should be indicated in a box, put ‘’ in the box of your appropriate choice.
3. A completed application form must be returned to the Registrar Office on/before the date
specified on the Academic Calendar.
This application form should be accompanied by:
The original and one photocopy of the Ethiopian School Leaving Certificate or its equivalent
The original and one copies of High school Transcript.
Original and one photocopies of any other official documents which you think will be of help
towards you admission.
Original and one photocopies of Ministry Card/ 4 (3x4) size photo
Registration Requirements: To registered in degree program candidates should be
Grade 12 completed with pass grade mark as of national cut point
Degree holder from recognized university
10+3, Diploma or Level 4 completed from recognized college with COC pass and one year
experiences
PAYMENT REQUIREMENTS
The students should expect to pay 300 birr for registration every semester
100 birr for ID card
HEALTH FACULTY’S REGISTRATION PAYMENT INFORMATION
Tuition fee will pay every semester per credit hour base
Common Course 190 birr per credit
Supportive Course 230 birr per credit Hours
Major Course 255 birr per credit hours
Lab request course 275 birr per credit
Research course 750
BUSINESS FACILITIES’ PAYMENT INFORMATION
Tuition fee will pay every semester per credit hour base
Common Course 175 birr per credit
Supportive Course 195 birr per credit Hours
Major Course 215 birr per credit hours
Lab request course 275 birr per credit
Research course 750
NB:-The payment per credit hours will revise every semester, or every year, if necessary
Classification of admission
a. Admission Type:
Regular Extension-1 Extension-2
b. Enrollment Type: TVET Level IV program Degree program
PERSONAL INFORMATION
Full Name (In English) Name Father G. father
(In Amharic):
Sex Male Female
Date of Birth (in Eth.Cal): Day____ Month ______ Year_______
(in G.C)Day____ Month ______ Year___________Nationality _______
Place of Birth: ___________________ ____________________
Country Region Zone Town Kebele [Woreda]
You’re current Address: city__________________ Sub city __________Kebele________
. Home Tel. Mobile No.
Person to be conducted in case of emergency:
Full Name: _____________________________Relationship _______________________
Address: Region Sub-city Woreda Village
House No. Home Tel Mobile No. Office Tel. P.O.Box
Your Father’s Full Name: ___________________________________ Tel. No. _________
Your mother’s Full Name: ___________________________________ Tel. No. _________
Educational Background
Senior secondary/preparatory school attended (Grade 11 & 12)
Name of school Town Zone Region
Examination Records
Select the exam category that is applicable to you and fill the results you scored.
ESLCE/EGSEC/Mark scored
Choose any seven courses for which you scored
High grade (including Maths and English)
Subject Grade Exam year
1) English __________________ __________________
2) Mathematics __________________ __________________
3) ___________ __________________ __________________
4) ___________ __________________ __________________
5) ___________ __________________ __________________
6) ___________ __________________ __________________
7) ___________ __________________ __________________
Average Result ___________________
The field you are enrolled to study
BSC In Nursing BA in Accounting
BSC In Public Health officer BA in Management
Statement by applicant
I hereby certify that all information given in this application form is complete, correct and accurate. I
fully realized that the college is entitled to take any action on me, including dismissal if the
information given by me here is found to be incorrect or misleading at any time. I also realized that I
will not be entitled to any reimbursement of whatever fee I might have paid in case when the college
takes any action on me as a result of any incorrect or misleading information given by me. I shall
also take full responsibility, for reading and abiding by the rules and regulations of the college
student Handbook deposited in the college Library system.
Student Name ____________________________ Date _____________Signature ______________
Office use only: I conformed all document attached here are legal and according to the
requirement.
Registered by:__________________Signature:______________________Date: ____________
