Haramaya University
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College of Continuing & Distance Education
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(025) 553- 00-20
Fax:
(025) 553-03-15 P.O.Box 63 Haramaya University
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Ethiopia
Web site: www.haramaya.edu.et
APPLICATION FORM FOR ADMISSION OF POSTGRADUATE EDUCATION PROGRAM
(Kiremt In-Service Program)
I. INTRUCTIONS
1. For clarity, please USE CAPITAL LETTERS TO FILL OUT THIS FORM.
2. Complete this application for in THREE COPIES.
3. Submit the following documents along with filled out application form.
(a) TWO COPIES of the official transcript of academic record of the Bachelor’s Degree.
(b) AN AUTHENTICATED PHOTO-COPY of the diploma.
(c) First Degree holders from universities outside Ethiopia must present a copy of results of
GCE or West African Schools Certificate of Oxford Examination or any other accredited
high school examination result paper.
(d) A postal order of 50 Birr to Haramaya University post office as an application fee
payable to Continuing & Summer Postgraduate Education Program.
4. NOTE: Applications must be submitted to Haramaya University main campus (Continuing and
Summer Postgraduate Coordination Office) to the address below until May31st, 2014.
Application through fax will not be processed.
SUMMER IN-SERVICE PROGRAM
HARAMAYA UNIVERSITY
P.O.BOX. 63
ETHIOPIA
5. The enclosed recommendation letters should preferably be mailed earlier directly by your referees
to the address above.
6. Tentative Entrance Examination Date: 02July 2014
NB. The payment for the course work of Postgraduate study (M.Sc/M.A.) is Birr 550/credit hour
Thesis supervision is Birr 4,500.00 and payment to thesis examiners Birr 4,500.00. The overall
tuition for 30 credit hours, supervision and thesis examiners fees is estimated Birr 26,
825.00(twenty six thousand eight hundred twenty five). If a student takes more than 30 credit
hours, additional tuition fees will be requested. This cost does not include fees for remedial/
bridging courses and research expenses.
7. Please Put an ‘X’ mark in the box of your choice
II.PERSONAL DETAILS
__________________
_______________
______________
Name
Father’s
Grandfather’s
Present address _____________________________________________________________
Province/Region ________________________ Town/City___________________________
P.OBox ___________________Country _______________________ (for foreigners)
Tel.____________________________ Fax _________________e-Mail________________
Home Address______________________________________________________________
Province/Region_____________________________Town/City_______________________
P.O.Box _________________________Country _____________________ (for foreigners)
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Tel.____________________________Fax___________________e-mail________________
Birth date ________________Month _____________Year _________(European Calendar)
Birth place ______________________
_____________________________________
Town/City
Region / Province / Country
Sex:
Male
Female
(Put Mark)
Marital status:
Single
Married
Divorced
Number of children or dependents:____________________________________________
Mother’s full name:________________________________________________________
Name of person to be contacted in case of emergency _____________________________
Address:_________________________________________________________________
Province/Region _________________________Town/City________________________
P.O.Box______________________ Country _______________________(for foreigners)
Tel.__________________________Fax___________________e-mail________________
I.
EDUCATIONAL QUALIFICATIONS
Degree
Diploma
Name of academic institution
Certificate
Location
Awarded
(Deg. Dip.)
(Put
Date of
award
mark)
Cumulative
GPA
State the field of study of your undergraduate degree program.
Major __________________________ Minor _____________________________
II.
WORK EXPERIENCE
State your present work ________________________________________________
Give the address of your present employer _________________________________
Province/Region ______________________Town/City ______________________
P.O.Box _____________________Country _____________________(for foreigners)
Tel. _______________________Fax __________________e-mail ______________
III.
RESEARCH
Give particulars on any relevant experiences you have. Give references to any
Published work you have done. Enclose copies if possible.
1.______________________________________________________________
______________________________________________________________
______________________________________________________________
IV.
REFERENCE
Give names and addresses of three persons, preferably undergraduate instructors, employers
and professional associates, to whom reference can be made about your ability. Specify your
association with each referee. Have each one fill out the enclosed recommendation forms.
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1. ________________________________________________________________
2. ________________________________________________________________
3. ______________________________________________________________
V.
COLLEGE APPLIED TO _____________________________________________
Proposed major study field: put “√” mark in one of the boxes below.
1. School of Agricultural Economics and Agribusiness
Agricultural Economics
Agricultural Marketing
2. School of Animal and Range Sciences
Animal Production
Animal Genetics and Breeding
Animal Nutrition
Rangeland Ecology & Management
Dairy Sciences
3.
School of Plant Sciences
Agronomy
Agricultural Entomology
Integrated Pest Management
Plant Pathology
Weed Science
Horticulture
Seed Science and Technology
Plant Breeding
4. School of Natural Resources Management and Environmental Sciences
Soil Sciences
Irrigation Agronomy
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5. School of Natural Resources and Environmental Engineering
Soil and Water Conservation Engineering
Irrigation Engineering
6. School of Food Science, Postharvest Technology and Process Engineering
Food Science & Technology
Post-Harvest Technology
Food Engineering
7.
Department of Rural Development and Agricultural Extension
Rural Development
Agricultural Communication and Innovation Development
8. Department of Biology
Applied Biology
Biology
Biotechnology
Genetics
Microbiology
9.
Department of Chemistry
Analytical Chemistry
Inorganic Chemistry
Organic Chemistry
Physical Chemistry
10. Department of Mathematics
Differential Mathematics
Numerical Mathematics
Optimization Mathematics
11. Department of Physics
Environmental Physics
Nano-Scale Physics
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Computational Physics
Applied Quantum Physics
Quantum Field Theory
12. Department of Sport Sciences
Coaching and Therapy Sciences
Teaching Physical Education
13. Department of Geography and Environmental Studies
Environment and Land Resource Management
Urban and Regional Development Planning
14. School of Foreign Language Studies
Teaching English as Foreign Language
15. Department of Educational Planning and Management
Educational Leadership and Management
16. Department of Sociology
Sociology
17. Department of Information Sciences
Information Sciences
18. College of Veterinary Medicine
Veterinary Public Health
Veterinary Epidemiology
Planned date of enrollment __________________________________________
I hereby certify that all information given in this document is complete and accurate.
Date ________________________Place _____________________________________
Name of applicant _________________Signature ______________________________
1. Financial Support
Give the name and address of the sponsoring organization of your graduate study.
Name of the sponsoring organization: ___________________________________________
Postal Address of your sponsor organization:_____________________________________________
Land Line number: ___________________________Mobile phone number: _______________
Fax number: ________________________________
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2. Statement by the student
I hereby certify that all the information given in this application is complete, correct and
accurate. I fully realize that the University is entitled to take any actions on me, including
dismissal at any time, if the information given by me here is found to be incorrect and
misleading. I also realize that I will not be entitled to any reimbursement whatever fee I
might have paid in cases where the University takes action on me as a result of any
mischievous information I might have given.
I shall also take full responsibility for reading and abiding by the rules and regulations
included in the University Student Handbook deposited in the University Library System.
Name: ______________________
Signature: _____________________
Date: _______________________
Place/Center: ___________________
DO NOT WRITE BELOW THIS LINE
______________________________________________________________________
TO BE COMPLETED BY THE CHAIRMAN OF THE COUNCIL OF GRADUATE STUDIES
Examination result, if any _____________________________________________________
Recommendation: Admitted
Not admitted
(Put
mark)
Please attach minutes of the College Graduate Commission (FGC) with the application form.
Name of advisor _______________________________________________________
Date of FGC approval __________________________________________________
Name of chairman ________________________ Signature ____________________
Chairman, College Graduate Commission __________________________________
College of ___________________________________________________________
Action by Council of Graduate Studies ______________________________________
Admission approved
Admission not approved
(put mark)
Date ____________________ ____________________________________________
_____________________________
Dean, School of Graduate Studies
_________________________________
Chairman, Council of Graduate Studies
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HARAMAYA UNIVERSITY
COLLEGE OF CONTINUEING AND DISTANCE EDUCATION
LETTER OF COMMITMENT & SPONSORSHIP OF THE EMPLOYER ORGANIZATION
(To be filled out and signed by the Head of the Organization)
The School of Graduate Studies (SGS) of Haramaya University appreciates your assistance in filling
out this form and sending it to the address below.
HARAMAYA UNIVERSITY
COLLEGE OF CONTINUEING AND DISTANCE EDUCATION
Summer In Service Program
P.O.BOX 63, Haramaya University, ETHIOPIA
On behalf of the candidate, namely ____________________________________________________,
the organization of which I am head is committed to grant financial support covering the living
expenses, tuition fee for course works, thesis research budget and employment in the course of
his/her postgraduate training. The financial support is intended to last until the completion of the
program of study. Moreover, I express the organization’s agreement to refrain from any obligatory
assignments of the candidate which may jeopardize his/her program of study.
Also, I am cognizant of the fact that the concrete realities of the country dictate that education in
general, and postgraduate studies in particular, must be geared towards the solution of specific
problems affecting the country. I am, therefore, aware of the fact that this specific training my
organization is fully sponsoring must be geared towards fulfilling a definite national purpose.
Accordingly, my organization is committed to maintain the monthly salary, pay the tuition fee and
thesis research budget and an appropriate position of employment after the abovementioned
candidate completes his/her postgraduate studies.
Total amount (tuition and supervision): Ethiopian Birr: Birr 26, 825.00(twenty six thousand eight
hundred twenty five).
First installment: 8,900(eight thousand nine hundred Birr)
Second installment: 8,925(eight thousand nine hundred twenty five Birr)
Third installment: 9, 000(nine thousand Birr)
Notice: Payment should be effective before registration of the course in each semester
Name ______________________________________________
Signature______________________
Position ____________________________________________
Organization ______________________________________________Date:____________________
P.O. Box _________________Town/City______________________
Country___________________
Fax: ______________________ Tel. ____________________Mobile:
_________________________
e-mail __________________________________________________
Please put the official seal.
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