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For Official Use

NOVEMBER ORDINARY LEVEL CANDIDATE DETAILS AMENDMENT FORM


Received by_______________
SHEET NUMBER_________OF__________
Date______________________
_
CENTRE NUMBER CENTRE NAME_____________________________________ YEAR____________

CANDIDATE CANDIDATE FULL NAME AS CORRECT NAME (FULL NAME) OTHER CANDIDATE DETAILS
Enter the correct details required F- Female,
NUMBER APPERING ON STATEMENT OF ENTRY (This column is to be completed for candidates M- Male, S- School, P- Private, B- Braille, E Enlarged
requesting for name amendment only) Print D-

Date of Sex Status Special


Birth Requirements

CENTRE HEAD ‘S SIGNATURE_________________________________


ZIMSEC REGIONAL OFFICE
DATE STAMP
CENTRE CELL/PHONE NUMBER (S) ___________________________ CENTRE DATE STAMP

Official Use- Effected by Date

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