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NATIONAL UNIVERSITY OF SCIENCE AND TECHNOLOGY

in collaboration with
MASVINGO POLYTECHNIC
BACHELOR OF SCIENCE HONOURS DEGREE IN FOOD SCIENCE & TECHNOLOGY
ADMISSION APPLICATION FORM 2023

A. FOR OFFICIAL USE ONLY

A.1 PROCESSED ON 1.8 CERTIFICATES RECEIVED

A.2 RECEIPT NO. Birth

Marriage
A.3 AMOUNT I.D.
‘O’ Level
A.4 RECEIVED BY ...........................................................
‘A’ Level
HEXCO
Other

Fill in the form clearly in ink in relavant sections provided. Applicants are encouraged to complete the form in
an honest manner. Falsified documents may result in automatic disqualification and / or prosecution.
B. PERSONAL DETAILS

B.1 SURNAME(S):

B.2 FORENAME(S):

B.3 DATE OF BIRTH: Day (e.g. 15) Month (e.g. 03) Year (e.g. 2008)

B.4 TITLE: MR/MRS/MISS/DR/MS/REV/SR: (for Mrs, attach marriage certificate)

B.5 PREVIOUS SURNAME:

B.6 MARITAL STATUS: Married (M); Single (S);Divorced (D); Widowed (W)

B.7 PLACE OF BIRTH .............................................................................................. .......................................

B.8 SEX: Male (M); Female (F)

B.9 ID NUMBER ........................................................................................................................................................................

(attach certified copy of ID)

B.10 RACE NATIONALITY

B.12 RELIGION ...........................................................................................................................................................................

B.13 ARE YOU A PERMANENT RESIDENT OF ZIMBABWE? Yes (Y); No (N)

IF ‘NO’, WHAT PERMIT DO YOU HOLD, IF ANY? ................................................................. (attach certified copy)

B.14 CITIZENSHIP ....................................................................................................................................................................

B.15 DO YOU SUFFER FROM ANY PHYSICAL OR OTHER DISABILITIES FOR WHICH SPECIAL
ARRANGEMENTS AT UNIVERSITY WOULD BE REQUIRED? Yes (Y); No (N) ....................................

IF ‘YES’, PLEASE GIVE DETAILS ...................................................................................................................

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B.16 CONTACT ADDRESS

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TELEPHONE NUMBERS: Home Number: ........................................................................................................

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Cell Number: ...................................................................................................................

EMAIL ADDRESS: ...................................................................................................................................................................

*N.B. All correspondence will be forwarded to the above address.

C. IMPORTANT NOTES TO ALL APPLICANTS

C.1 The section of this application form must be completed by applicant themselves carefully and legibly. The polytechnic
reserves the right of admission in any case and it will reject an application if it identify falsified information or documents
and may refer the matter for legal action.

C.2 Applicants must endorse at the bottom of this page that they have understood the notes given below and that
they agree to their application being considered under the conditions outlined below.

C.3 Applicants should submit this form to Masvingo Polytechnic, The Principal, Attention: BTech Coordinator P O Box 800,
Masvingo, Zimbabwe.
C.4 The closing date for receipt of applications for admission is as advised in the published advert.

C.5 All applicants MUST submit, with this form, photocopies (NOT originals) of all qualifications/certificates referred to
in the application including birth certificates and I.D. cards. Special entries should include CVs. The copies of certificates
must be certified by a Commissioner of Oaths or Head/Principal of the institution at which the examinations were taken.

C.6 ONLINE APPLICATIONS: Applicants are also required to submit an online application on the email:
btechmasvingo@gmail.com
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•Any applicant who falsifies or submits fake examination results will face prosecution and automatic disqualification.

D. SCHOOL EXAMINATION RESULTS

(List in ALL passed subjects and results as they appear on the certificate, and attach certified copies of certificates.)
DATE
EXAMINING BODY LEVEL RESULT/
(e.g. ZIMSEC, Cambridge) (e.g. O, M, A, CSC, etc.) SUBJECT
GRADE
Month Year

“O” English Language

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“O” Mathematics
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“A”
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E. SCHOOLS ATTENDED (or College or Polytechnic at which school-leaving examinations were taken)

6.1 HIGH SCHOOL LAST ATTENDED ..........................................................................................................................................

(If outside Zimbabwe, indicate country) (Name) .......................................................................................................................

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PERIOD OF ATTENDANCE: START YEAR (e.g. 01)

END YEAR (e.g. 02)
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F. PROSPECTIVE SPONSOR(S)

ARE YOU A UNIVERSITY STAFF DEPENDANT (i.e. wife, husband or child)? Yes/No (delete the inapplicable)

ARE YOU A UNIVERSITY STAFF MEMBER? Yes/No

IF ‘YES’ PLEASE GIVE NAME, DEPARTMENT AND TELEPHONE EXTENSION OF STAFF MEMBER

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Signature of Applicant .................................................................................................. Date ..........................................................