REFERRAL STUDENT DETAILS:
FULL NAMES:
………………………………….
PHONE
No……………………………………….
STUDENT’S ID
No………………………………
DIPLOMA/ DEGREE / MASTERS
APPLICATION FORM
TEL: 260977106341/ 0965467690/ 0977518075 K150.00
Email: admissions@[Link]
[Link]
TICK APPROPRIATE PROGRAMME AND INTAKE
1. SCHOOL OF MEDICINE:
Full Time Intake In service/ Distance Intake
[ ] January [ ] May
[ ] July [ ] November
[ ] Bachelor of Medicine and Bachelor of Surgery (MBChB) (full time only)
School leavers
(Entry to Natural Sciences - ‘A’- levels)
Direct entry
(With ‘A’- levels from other institutions (minimum of 2yrs)
Degree holders in medical fields
(Holders of Bachelor’s degree in medical related fields; exemptions shall apply).
[ ] Bachelor of Science in Clinical Medicine
[ ] Bachelor of Science in Environmental Health
[ ] Diploma in Clinical Medicine – General
[ ] Diploma in Environmental Health
[ ] Master of Science in Public Health
2. SCHOOL OF EDUCATION, HUMANITIES AND SOCIAL SCIENCES
Full Time Intake In service/ Distance Intake
[ ] January [ ] May
[ ] July [ ] November
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Department of ICT
[ ] BSc in Digital Marketing and E-commerce
[ ] Bachelor of Science in Information and Communications Technology.
[ ] BSc Cyber security and Network Defense
[ ] BSc Data Science and Big Data Analytics
[ ] MSc Cloud Computing and DevOps
[ ] MSc Artificial Intelligence
[ ] MSc Cyber security and Digital Forensics
[ ] MSc Data Science and Analytics
Department of Humanities and Social Sciences
[ ] Bachelor of Social Work
[ ] Bachelor of Arts in Developmental Studies
[ ] Bachelor of Arts in Sociology
[ ] Bachelor of Science in Public Administration and Political Science
[ ] Bachelor of Science in Hospitality, and Hotel Management
[ ] Bachelor of Science in Hospitality, Tourism and Travel
[ ] Bachelor of Science in Interior Design
[ ] Bachelor of Science in Disability Studies
[ ] Bachelor of Science in Event Planning
[ ] Bachelor of Arts in Peace, Security and Intelligence Management
[ ] Bachelor of Arts in Sports Management
[ ] Bachelor of Science in Psychology
[ ] Master of Science in Sports Management
[ ] Master of Science in Psychology
[ ] Master of Arts in Sociology
[ ] Master of Science in Social Work
[ ] Master of Arts in Peace, Security and Intelligence Management
[ ] Master of Arts in Peace and Conflict Resolution
[ ] Master of Science in Disability Studies
[ ] Master of Arts in Special Education
2
Department of Education
[ ] Bachelor of Business Administration and Entrepreneurship with Education
[ ] Bachelor of Arts in Guidance and Counselling with Education
[ ] Bachelor of Science with Education – Secondary
[ ] Bachelor of ICT & Entrepreneurship
[ ] Bachelor of Arts with Education – Primary
[ ] Bachelor of Arts with Education – Secondary
[ ] Diploma in Secondary Teaching
[ ] Diploma in Secondary Teaching
[ ] Diploma in Primary Teaching
[ ] Diploma in Early Childhood Education
[ ] Diploma in Teaching Methodology
[ ] Master of Education Management and Administration
[ ] Master of Guidance & Counselling
[ ] Master of Education – Specializations
[ ] Postgraduate Diploma- Teaching Methodology
3. SCHOOL OF PHARMACY
Full Time Intake
[ ] January
[ ] July
[ ] Bachelor of Pharmacy
[ ] Diploma in Pharmacy
4. SCHOOL OF NURSING AND MIDWIFERY SCIENCES:
Full Time Intake In service/ Distance Intake
[ ] January [ ] May
[ ] July [ ] November
[ ] Bachelor of Science in Midwifery Nursing
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[ ] Bachelor of Science in Nursing
[ ] Diploma in Public Health Nursing
[ ] Diploma in Nursing
[ ] Diploma in Midwifery
5. SCHOOL OF NATURAL SCIENCE:
Full Time Intake
[ ] January
[ ] July
[ ] Bachelor of Science in Chemistry
[ ] Bachelor of Science in Ecology and Conservation Biology
[ ] Bachelor of Science in Molecular Biology
[ ] Bachelor of Science in Fire Engineering and Rescue Mgt.
6. SCHOOL OF LAW & BUSINESS STUDIES
Full Time Intake In service/ Distance Intake [ ] Part-time [ ] Weekends [ ] On line
[ ] January [ ] January
[ ] July [ ] July
[ ] Bachelor of Laws (LLB)
[ ] Bachelor of Science in Business Management
[ ] Bachelor of Science in Accounting and Finance
[ ] Bachelor of Science in Banking and Finance
[ ] Bachelor of Science in Human Resources Management
[ ] Bachelor of Science in Marketing
[ ] Bachelor of Science in Economics and Finance
[ ] Bachelor of Science in Logistics, Fleet and Transport Management
[ ] Bachelor of Science in Purchasing and Supply Chain Management
[ ] Master of Business Administration (Finance & Accounting, Marketing)
1. FULL NAMES (Surname, First Name and Middle Name) (each letter to be in a box)
Other qualifications: ………………………………………………………………………………………
2. From the FIRST PAGE please choose and indicate the programmes for which you wish to be considered in order of
reference below.
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First choice………………………………………………………………………………
Second choice…………………………………………………………………………...
2. Sex: Male Female
Marital Status: Married Single Divorced Separated Widow
Date of Birth: ……………………………………………………………….
Nationality: …………………………………………………………………
National Registration Card No: …………………………………………….
OR
Passport No. for non-Zambians: ……………………………………………
3. Residential Address: ……………………………………………………………………………………
4. Last Secondary School Attended
……………………………………………………………………………………………………………………….
5. Name, Address and Telephone Number(s) of next of kin
………………………………………………………………………………………………………………
6. Your Telephone Number(s) if any: Business Telephone: …………………………………………….
Telephone: Mobile/Cellular Phone: …………………………………………….
Email Address (if any) ……………………………………………………………………………..........
7. If you have previously enrolled as a student at Eden University. Indicate your
Student/ Computer Number: …………………………………………
Program: ………………………………………………………………
Year Last Enrolled: ……………………………………………………
(Please attach a transcript of your last examination result if you have been previously enrolled at any university)
Are you currently engaged in any studies? Yes No
If yes state the nature and type of studies and qualification sought, including examination body
………………………………………………………………………………………………………………
8. Do you have any physical or communication disabilities? Circle the number applicable.
a. 1. Vision
2. Mobility
3. Speech
4. Hearing
5. Others
b. If you have any disability, give details
………………………………………………………………………………………………………………………………………………
……………………………………………………………………………………………………
9. ‘O’ level or equivalent examinations passed and grades attained in each subject.
Subjects Grades Names of Examination Board
…………………………… ………. ………………………………
.………………………….. ………. …………………………………..
.…………………………... ………. …………………………………..
…………………………… ………. …………………………………..
…………………………… ………. …………………………………..
…………………………… ………. ………………………………….
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Enclosed certified copy (ies) of statement (s) of results and certificates, application forms which are not accompanied with
copies of statements of results will not be processed.
10. FILL THIS PART IF YOU ARE PRESENTLY EMPLOYED
(a) Type of Employment or job ……………………………………………………
(b) Name of Employer………………………………………………………………
(c) Address of Employer…………………………………………………………….
(d) Period of service………………………………………………………………….
(e) TS/Employee’s reference No…………………………………………………….
11. How did you know about us? Please tick your answer;
Through a radio station
From our posters/flyers
From our Zambian News papers
Through our television adverts
From our billboards
From one of our Student
Any other; …………………………………………………………………
Signature of applicant…………………………… Date ……………………………………
For the payment of application form fee, kindly consider this bank account to avoid being scammed.
ACCOUNT NAME: EDEN UNIVERSITY LIMITED
BANK NAME: ZAMBIA NATIONAL COMMERCIAL BANK PLC
BANK ADDRESS: ZANACO BANK PLC. PO BOX 33611, CAIRO ROAD, LUSAKA ZAMBIA
ACCOUNT NUMBER: 5145589500133 – ZMW
BRANCH: ACACIA PARK
SWIFT CODE: ZNCOZMLU
BRANCH CODE: 010086