Malawi Institute of Management

APPLICATION FORM
UNDERGRADUATE /POSTGRADUATE
PROGRAMME
(Please use Block Letters throughout)

1. PERSONAL DATA

Surname: _____________________________Title: MR./DR/MRS/MISS

First Name:_________________________-Initials:__________________

Date of Birth--------------------------------------------------------------------------

Contact Address: _____________________________________________

___________________________________________________________

Telephone.:________________________Mobile:____________________

Email Address:_______________________________________________

2. DETAILS OF NEXT OF KIN/GUARDIAN

Surname: _____________________________Title: MR./DR/MRS/MISS

First Name:_________________________-Initials:__________________

Contact Address: _____________________________________________

___________________________________________________________

Telephone.:________________________Mobile:____________________

Email Address:_______________________________________________

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 3. CURRENT EMPLOYER (Mature Entry / Post Graduate Only)

Address: ___________________________________________________

Telephone No.: _____________________ Fax:____________________

Email: __________________________________________________

Sponsor: ______________________________________________

4. WORK HISTORY (Mature Entry / Post Graduate Only)

Position From To Responsibilities

5. PROGRAMME APPLIED FOR:__________________________________

___________________________________________________________

6. MODE OF STUDY ( Please tick)

 Full Time
 Block Release
 Evening Classes
 Week-End Classes

7. ACADEMIC QUALIFICATION (Highest Level Attained)

 Masters
 Bachelors
 Diploma
 MSCE
 Other(specify)____________________________

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8. MALAWI SCHOOL CERTIFICATE OF EDUCATION (MSCE)

Year Subject Aggregate Points

Obtained

9. STATEMENT IN SUPPORT OF YOUR APPLICATION

(POSTGRADUATE ONLY)
_________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________
___________________________________________________________

10. REFERENCE (POST GRADUATE ONLY)

Name of Referee: _______________________ _________________

Position and Occupation:__________________________________

Contact Address: _____________________________________________

___________________________________________________________

Telephone.:________________________Mobile:____________________

Email Address:_______________________________________________
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 11. FEES

50% of the fees should be paid to the Institute before commencement of

the programme to secure student’s place.

Return to: The Registrar

2018 Admissions (Cohort IV)
Malawi Institute of Management
P.O. Box 30801
Lilongwe 3.
Tel: +265999975954 or +2651 710 866
Fax: +2651 710 609

Email: admissions@mim..ac.mw

Note: Please return this form with a CV, certified copies of certificates, academic
transcripts and two passport size photos and an application fee of K10, 000.00
MUST be deposited to the following account:

Account Name: Malawi Institute of Management – Fees Account

Account Number: 1001622745
Bank: National Bank of Malawi
Branch: Capital City

12. DECLARATION AND SIGNATURE

I hereby declare that the information given is correct and true in all respect.

SIGNATURE: _______________________ DATE: _________________