Institute of Water and Sanitation Development

P O Box MP422
Mt Pleasant
Harare
Email: training@iwsd.co.zw

Receipt No.: ……………

APPLICATION FORM

COURSE APPLIED FOR: ……WASH……Post…Graduate…

Diploma………………………………………………………. YEAR:……2022…………

APPLICANT’S DETAILS

SURNAME……
NCUBE………………………………………………………………………………………………………….......

OTHER NAMES……… ……EMILY……

ROSINA…………………………………………………………………………………..

DATE OF BIRTH……………28/08/1993……………………….. MALE/FEMALE ……………………

FEMALE…………………………..

NATIONALITY…………
ZIMBABWEAN…………………………………………………………………………………………………….

I. D. NUMBER: ……………58-
282555C02……………………………………………………………………………………...
ADDRESS FOR CORRESPONDENCE……………………………………………………………………………...…..
……729 DULIBADZIMU TOWNSHIP
BEITBRIDGE………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………………
……………
TELEPHONE…………0774893265……………………………………………….
FAX………………………………………………

EMAIL (a requirement): …………………………………………………………………

emilyncube71@gmail.com………………………………………………….

EDUCATIONAL BACKGROUND

QUALIFICATION MAJOR SUBJECTS DATES

A level Mathematics A November
Physics B 2012
Chemistry D

Degree from the National University Bachelor of Engineering Honors degree in Electronic 2018
of Science and Technology Engineering
Certified copies of educational qualifications, identification, birth certificate and curriculum vitae must be
attached to this application form.

EMPLOYMENT HISTORY

CURRENT EMPLOYER:………OASIS
COLLEGE…………………………………………………………………………………………

POSITION: …MATHS AND SCIENCE

TEACHER……………………………………………………………………………………………………………...

ADDRESS: ……………694 Baobab road………

Beitbridge…………………………………………………………………………………………..

TELEPHONE:--------------0772348910------------------------FAX:-----------------------------------------------------------

E-MAIL: -------------------------------------------------------------------

EMPLOYER POSITION TITLE & PERIOD

Major area of responsibility
August 2016 to
Fuzzy Electronics Electronic Engineering intern August 2017

January 2020 to
Computer Gurus Assistant Technician. March 2020
Computer repairs and maintenance

Beitbridge Electronics Assistant Technician May 2020 to April

Electronic gadget repairs 2021

FINANCIAL SUPPORT

SPONSOR’ S NAME: ………………………………………………………………………………………………….

ADDRESS: ………………………………………………………………………………………………………………

CONTACT PERSON: ……………………………………………………………………………………………………

TELEPHONE NO: ………………………………………………………………………………………………………

FAX: ………………………………………. EMAIL ADDRESS: ……………………………………………………..

[ ] I have already been offered financial support

[ ] I will apply for financial support if accepted on the course.

 [ ] I will pay for my tuition fees.

(Tick in appropriate box).

SIGNED ……………RE Ncube……………………………. DATE……28/12/2021…………………………..

…

An application fee will be charged for handling applications. For more information contact
training@iwsd.co.zw