RECEIPT NO. Education for Efficiency TANZANIA INSTITUTE OF ACCOUNTANCY (TIA) APPLICATION FM F POSTGRADUATE DIPLOMA Affix Photograph Here NOTE (1) This application form should strictly be used for 2013/2014 Academic Year only which start in September, 2013; (2) Applicant must READ and UNDERSTAND all the information given in this form before filling it; and (3) When completing this form please use CAPITAL LETTERS or PRINT. (4) Attach with photocopies of genuine certificates PART (A): TO BE COMPLETED BY APPLICANT 1. Name (in full) Mr./Mrs/Miss:. 2. (a) Date of Birth: (b) Male/Female:.. (c) Marital Status: SINGLE / MARRIED ( d) Nationality:.. (e)contact Address:. Telephone/Mobile E-Mail: 3. (a) Service Particulars: (F IN SERVICE ONLY) (i) Date of First Appointment:.. (ii) Designation:.. (iii) Present Post: (iv) Brief Details of Current Duties:.. (v). Name and Address of Place of Work:.. (b) Particulars of Previous Work Experience: POST HELD NAME OF EMPLOYER DATES FROM TO............................. 1
PARTICULARS OF EDUCATION AND PROFESSIONAL QUALIFICATIONS: (a) Educational Qualifications: NAME AND ADDRESS OF THE SECONDARY SCHOOL SUBJECTS TAKEN PASS GRADES DATE ACQUIRED EXAM NO./INDEX NUMBER O LEVEL.................. A LEVEL........... (b) Professional Qualifications: NAME AND ADDRESS OF THE INSTITUTION LEVEL OF PROFESSIONAL SUBJECTS TAKEN PASS GRADES DATE ACQUIRED..... 2
4. COURSE APPLIED F AND CAMPUS: (PLEASE TICK IN THE PROVIDED BOXES): POST GRADUATE DIPLOMA COURSES: ( i) POST GRADUATE DIPLOMA IN ACCOUNTANCY (PGDA) DAR ES SALAAM ( ), MBEYA ( ) & MWANZA( ) FULL TIME( ) EVENING ( ) (ii) POST GRADUATE DIPLOMA IN PROCUREMENT & LOGISTICS MANAGEMENT (PGDLM) DAR ES SALAAM ( ), MBEYA ( ) & MWANZA( ) FULL TIME( ) EVENING ( ) 5. APPLICANT S DECLARATION: I certify that to best of my knowledge the information given by me here above is true, complete and correct, should any of the information is found to be untrue any legal measures may be taken against me at any time. Date: Signature of Applicant: PART (B): TO BE COMPLETED BY SPONS (1) F IN-SERVICE APPLICANTS ONLY: I, the undersigned (Name and Address of Sponsor). (i) (ii) (iii) Nominate (Name of Applicant) For (Name of the Course) And if accepted, I undertake to pay for all expenses relating to the Course. Certify that the applicant, if accepted as a student in the Course, will receive leave of absence for the duration of the Course. Certify that the applicant, if accepted will be given no other duties or assignment that would conflict with devoting full time and attention to the Course. Sponsor s Signature: Sponsor s Title: Official Stamp: Place: Date:. 3
(2) F PRE-SERVICE, PRIVATE AND SELFSPONSED APPLICANTS ONLY: (i) (ii) (iii) (iv) (v) (vi) Name of the Sponsor:.. Sponsor s Address: Sponsor s Title: Signature of the Sponsor:.. Official Stamp:.. Date: PART (C) RELEVANT INFMATION 1. MINIMUM ENTRANCE QUALIFICATIONS: (A) Bachelor Degree or Advanced Diploma in Accountancy or Procurement from any reputable institution (B) NBAA CPA Intermediate Stage (C) PSPTB CPSP Intermediate stage 2 Programme duration: One year 3 All Programmes Start in SEPTEMBER of each year and applications must reach the Institute not later than 30 th July 2013 4 Training Costs: Fees are payable full in advance. You will not be admitted unless your Sponsor (s) or Employer have paid the fee. An invoice of required fees may be obtained from the Institute on request. However, Fee Structure has been attached herewith for your guidance. Paid fees are not refunded and the fees are subject to revision at any time. 5. Duly completed Application Form accompanied by COPIES of relevant Certificate(s)/statement of results (marked true copy of the original) as stated in this form should be forwarded directly to: THE CHIEF EXECUTIVE OFFICER, TANZANIA INSTITUTE OF ACCOUNTANCY (TIA), AT THE JUNCTION OF NELSON MANDELA AND KILWA ROAD, 4
P.O. BOX 9522, DAR ES SALAAM. MBEYA CAMPUS, MWANJELWA AT THE JUNCTION OF ZAMBIA AND AIRPT ROAD, P.O. BOX 825, MBEYA. AT THE JUNCTION OF MWANZA AND AIRPT/SEPUKA ROAD, P.O. BOX 388, SINGIDA. AT THE SABASABA GROUNDS, P.O. BOX 169, MTWARA, LOCATED AT NYAKATO AREA ALONG MUSOMA ROAD (NEAR BUZURUGA BUS STAND) P.O. BOX 5247, MWANZA, 6 It is a criminal offence to submit false document to support your application. Any applicant who will be discovered having submitted a forged Certificate will be reported to the appropriate authority for legal action. NB: Forms must be accompanied by evidence of payment of non refundable fee of Twenty thousand (shs.20, 000/=). Applicants should pay application fee through any NMB Branch our Account No. 2061100017 NMB clearly addressed to CHIEF EXECUTIVE OFFICER, TANZANIA INSTITUTE OF ACCOUNTANCY and submit Bank Pay-in-slip to the Institute. 5
FEES STRUCTURE F ACADEMIC YEAR 2013/2014 TUTION FEE 1,800,000 REGISTRATION FEE 30,000 RESEARCH PAPER 200,000 TIASO FEE 10,000 COMPUTER FEE 10,000 The Institute has a limited number of hostel accommodations. Hostel accommodation cost per person is Tshs 300,000 per year. NOTE: The following RECOMMENDED ALLOWANCES are Payable to the Student directly by the Sponsor and are not included in the Course Fee: (1) Book allowance TShs. 500,000/= (2) Stationery allowance TShs. 250,000/= and Calculator TShs. 50,000/= (3) Meal allowance of TShs. 3,750,000/= per annum. (4) Medical Allowance TShs. 100,000/=. (5) Field Allowance 1,800,000/= F FEIGN STUDENTS: Postgraduate Diploma Course Students: The Total Fees is US $ 3500 p.a. THE ABOVE FEES ARE F 2013/2014 AND CAN BE REVISED ANY TIME. 6