APPLICATION FORM FOR RETURNING STUDENTS TO

APPLY FOR CHANGE OF QUALIFICATION IN 201 7

1.

PERSONAL DETAILS

UNISA STUDENT NUMBER

Surname

K.C

Y8

Y
9

M
1

Single

M
1

D
2

Married

I.D (RSA) Number or

Passport
Number
Foreigners)

8D

Z N 1 4 4

Divorced

9 8

+27843152518

Email Address
2.

KAKUNGU CHITAKWA

Full Names

Marital status (Mark with an X)

Cellular
Number

CHITAKWA

Initials

Date of Birth

kaksaratsy@yahoo.com

CURRENT QUALIFICATION
Most recent Qualification
registered
Qualification Code

3.

Stream (where applicable)

PROPOSED QUALIFICATION

Proposed New Qualification

Qualification Code
4.

Bachelor of Science Honours in Computing

9

Stream (where applicable)

TERTIARY INSTITUIONS PREVIOUSLY ATTENDED (COMPLETED AND INCOM PLETED STUDIES MUST BE INDICATED)

Institution(s) eg Unisa

Degree(s)/ Diploma(s)
eg BA

Nanchang Hang kong

University

B.Eng Aeronautical
Engineering

St Andres High School

5.

Year(s) eg 1994 1996

Grade 12 certificate

2011 - 2014

Student number(s)
eg 12345678

2010P91040605
00013

2006-2008

If completed, state year(s)

eg 1996

2014
2008

DECLARATION AND UNDERTAKING

I declare that all the particulars furnished by me on this form are true and correct. I undertake to comply
with the rules, regulation and decisions of the university and any amendments thereto, and I have taken
note of advice which may be applicable to students in general.
Surname
Applicants signature

CHITAKWA

Initials
Date

**The University reserves the right to request original documents or additional documents

K.C
9/12-2016