BESHA COMMUNITY ORGANIZATION

BESHA HEALTH TRAINING INSTITUTE

PHOTOGRAPH

For quality health training

BESHA Community Organization

For quality Social Services

P. o. Box 5025, TANGA, TANZANIA.

Mob: +255784527574, +255768527625 or
+255719150371
Website: www.BHTI.ac.tz

Our ref.

BESHA HEALTH TRAINING INSTITUTE - APPLICATION FORM FOR PRE- SERVICE COURSES
ACADEMIC YEAR 2016/17
Names:

Surname:

Middle name:

First name:

Sex:

Nationality:

Date of birth:

Place of Birth:

Secondary Education (tick in

appropriate place):
Secondary school(s) attended:

Form IV:

Year:

Form VI:

Year:

O Level:
A Level:

Indicate grades scored for each

subject:

Form IV: Biology:

Mathematics:
Geography:
Form VI: Biology:

Chemistry:
English:
History:

Chemistry:

Physics:
Kiswahili:
Civics:
Physics:

Course (Specify the course which you

intend to undertake) only one (see
page 2):
Applicants postal address:
Applicants other contacts:

Parents /Guardian name and address:

Mobile No:

Fax No:

Telephone No:

E-mail Address:

Full Name:
Full Address:
Telephone No:
1

Mobile:

INSTRUCTIONS TO ALL APPLICANTS:

(a) None refundable Tshs 25,000/= for Tanzanian residents or USD 20.00 for non-residents
registration fee should be paid for each application form.
The money should be deposited in the BESHA Health Training Institute Account No.
41710003703, National Microfinance Bank for Tanzanian residents, or Account No.
0502748002 of Diamond Trust Bank, TANGA BRANCH for non-residents respectively.
(b) Each application form is meant for one course.
(c) Attach the following:
i. Two recently passport size photographs, bearing the name and signature of the
applicant on the bank
ii. Original Bank pay in slip for the deposited money for online applicants.
iii. Certified copies of Ordinary/Advanced Secondary Certificate, Leaving Secondary
Certificate.
iv. Certified birth certificate
(d) Applicants who completed their Secondary school education outside the country should
attach their equivalent qualifications obtained from the National Examination Council of
Tanzania, for their academic certificates, or hand over their original certificates early
enough for procession of the same.
(e) The application form is available in the website of the Institute: www.BHTI.ac.tz
(f) Submit your application form to the Principal, BESHA Health Training Institute, P.O.Box
5025, TANGA TANZANIA before 31st August, 2015.
(g) The academic year will start in September, the date of which will be notified in Joining
instructions.
List of Courses
Diploma courses:
Diploma in Clinical Medicine leading to qualification as Clinical Officer

A. Certificate Courses
(i)
Certificate in Clinical Medicine Clinical Assistant)
(ii)
Certificate in Medical Laboratory Technology.
N.B Certificate in Nursing (Nurse Grade B) will start in next academic year.