DON BOSCO TECHNICAL INSTITUTE DODOMA

P.O BOX 964, DODOMA - TANZANIA AFFIX YOUR

Website : www.donboscododoma.org CURRENT PHOTO
Email : principal@donboscododoma.org HERE
Mobile Phones : +255 (0) 759 005 337
+255 (0) 756 308 518

APPLICATION FORM FOR ACADEMIC YEAR 2021

Instruction: Fill the form with your names as they appear from your academic certificates i.e.
STD VII Certificate, NVA, CSEE, or equivalent qualifications. A dully completed form should
be attached with copies of Academic Certificates. Birth Certificate and Affidavit is optional.

1. Personal information (Use CAPITAL letters)

First name Middle name Last name Gender

Date of Birth Place of Birth Home Address Marital Status

Email Address Citizenship

Mobile Number Parent/Guardian Full name Parent/Guardian Contact Relationship

2. Date of submission

Application forms submission commences on 25 th December and classes for Academic year 2021 starts on
14 th January, 2021.

3. Proposed course and level of study

No. Name of Course Tick

1. Electrical Installation
2. Masonry and Bricklaying (MB)
3. Plumbing and Pipe Fitting (PPF)
4. Information and Communication Technology (ICT)
5. Fitter Turner (FT)
6. Carpentry and Joinery (CJ)
7. Welding and metal Fabrication
8. Motor Vehicle Mechanics (MVM)
4. Entry Qualifications

COURSE QUALIFICATION

Electrical Installation, Motor Vehicle Mechanics, Fitter Mechanics and At least certificate of
Information Technology (ICT) secondary education (CSEE).

Masonry and Bricklaying (MB), Welding and Metal Fabrication (WF), At least certificate of primary
Carpentry and Joinery (CJ), Plumbing and Pipe Fittings (PPF) school education (PSLE).

5. Education Background

Certificate of Primary Education Examination.

A. Name of School ..................................................................................

B. Region .......................................................... .........................................

C. Year Completed ........................................... .........................................

Certificate of Secondary Education Examination (CSEE) ( Tick if you have attended ).

Name of School

Year
Index Number Division
Completed

Subject Grade Subject Grade

6. Fee stucture for Academic Year 2021

PARTICULARS MHULA WA KWANZA MHULA WA PILI

CAPENTRY, MOTOR VEHICLE CAPERNTRY , MOTOR VEHICLE

MASONRY, MECHANICS, MASONRY, MECHANICS,
WELDING,FITTER ELECTRICAL, WELDING,FITTER ELECTRICAL,
MECHANICS PLUMBING, ICT MECHANICS PLUMBING, ICT

ADA YA CHUO 275,000/= 300,000/= 275,000/= 300,000/=

BIMA YA AFYA NHIF ( kwa 50,400/= 50,400/= 0 0

waleambao hawana bima)

SARE: Shati, 80,000/= 80,000/= 0 0

Tisheti,Suruali, Ovaroli, na
Kitambulisho

CHAI 40,000/= 40,000/= 40,000/= 40,000/=

MAINTANANCE 50,000/= 50,000/= 50,000/= 50,000/=

JUMLA KUU 495,400/= 520,400/= 365,000/= 390,000/=

7. TERMS OF PAYMENTS

All Payments indicated above in (Part 6) should be made throught

BANK NAME : CRDB Bank

ACC NO : 0150284088500

ACC NAME : Don Bosco Technical Institute.

8. Declaration by the applicant

I ..................................................................................., hereby certify that the information given in this

application form is correct and accurate for the best of my knowledge.

Signature of applicant Date

....................................................................... .......................................................................

9. For Official Use Only

Date of Receipt Receipt Number

....................................................................... .......................................................................