MIDLANDS STATE UNIVERSITY

ADMISSIONS, REGISTRATION AND STUDENT STATISTICS

Exemption Form

Surname …………………………………. First Name(s) …………………………….

Registration No …………………Level ……………Sex……………………………….

Faculty………………………………………..Department………………………………

Period …….Jan- July /Aug-Dec 20 ……………………………

Mode of Entry (Tick Appropriate) Conventional, Parallel, Visiting School or Block

Release

LIST MODULES TO BE EXEMPTED IN THE TABLE BELOW

Module Code Module Description

Applicant’s Signature…………………………………. Date………………………….

Departmental Chairperson…..………………………… Date ………………………

Administrator - Faculty ……………………………….. Date ………………………
Admissions, Registration …………………………….. Date ………………………

Approved/Not approved
Deputy Registrar ……………………………………… Date ………………………