NATION PUBLICATIONS LIMITED

SELF-MANAGED LEARNING
REGISTRATION FORM
Part 1:

To be completed by employee

Name:………………………………………………………..………………………
Grade:…………………………
Department:……………………………………………………………………
Current Highest Educational/professional Qualification:
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CURRENT APPLICATION
I apply to study
Name of
Program…………………………………………………………………………………
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Examining Body:
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Qualification To Be Obtained:
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State motivation for pursuing learning programme. Tick the
three most important motivations
1. Improve current performance in current job

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2. Improve or acquire new skills

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3. Extend relevant knowledge

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4. Develop specified area of competency

[ ]

5. Moving across or upward within NPL

[ ]

6. Preparing for changes in the current role

[ ]

Subjects/modules (List them down):
Subject
Examination Date
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Mode of attendance:
[ ] Home study

[ ] Day release

[ ] Weekend

Expected Date of Completion:
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Signature:…………………………………………………………………….
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Date:

Part 2:
To Be Completed by Head of Department in
consultation with Immediate Supervisor
I recommend/do not recommend.
State reasons
a) Recommend:
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b) Do not recommend:
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Name:……………………………………..……….. Signature:
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Part 3:
Manager

To be completed by Learning & Development

I recommend/do not recommend
State reasons:
a) Recommend:
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b) Do not recommend:
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Name:……………………………………………… Signature:
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Part 4: To be completed by Chief Executive Officer
I approve/do not approve
State reasons:
a) Approved:
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b) Not approved:
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Name: ………………………………………………………
Signature……………………. Date:……………………