THE INSTITUTE OF FINANCE MANAGEMENT WEEK-END COLLEGE REVIEW CLASSES FOR THE TANZANIA INSTITUTE OF BANKERS’S EXAMINATIONS APPLICATION FORM (FOR JUL - NOV 2012) FOR OFFICIAL USE ONLY RECEIPT NUMBER DATE OF RECEIPT AMOUNT REGISTRATION AND TUITION FEE SUBJECTS: _____________ ________________ _____________ ____________ ADMISSION NUMBER: TIOB/_______________________ I. INSTRUCTION 1. This form is to be completed with the applicant and sponsor/employer 2. The applicant should return the form with two passport size photos-one stamped on the space provided the other for an identification card. 3. The form should be given back with registration and tuition fees. 4. If the applicant will be sponsored by an organization, the organization’s nominating official should fill and stamp in section VI 5. All payments should be made Management Bank Account: and addressed to The Institute of Finance CRDB; PPF TOWER BRANCH DAR ES SALAAM AC/ NO: 01J1042984102 Payment slip should be taken to: IFM Block A, Third Floor, Room 320 II. REVIEW STAGE AND SUBJECTS APPLIED FOR (Please tick the appropriate) Banking Certificate Certified professional Banker TICK 1. Principles of Economics 1. Financial Analysis 2. 2. Management Practice 3. Principles of Marketing and Business Ethics Accounting 3. 4. 5. Principles of Banking Principles of Law 4. 5. 6. Principles of Management 6. 7. Information Technology 7. The Monetary and Financial Systems Law Relating to Banking International Trade Finance Strategic Marketing Management Lending 8. Financial Services TICK NAME OF THE STAGE AND LEVEL/MODULE YOU ARE APPLYING FOR: __________________________________________________________ III. APPLICANTS PERSONAL PARTICULARS SURNAME ___________________________________________ FIRST NAME:_________________________________________ MIDDLE NAME: ______________________________________ DATE OF BIRTH:______________________________________ SEX: ___________________PLACE OF BIRTH:_____________ MARITAL STATUS:___________________ NATIONALITY:_________________________ ADDRESS:_____________________________________________________ TELEPHONE NUMBERS:__________________________________________ E-MAIL ADDRESS:______________________________________________ PERSON TO BE NOTIFIED IN CAE OF EMERGENCY: NAME: _______________________________________________________ ADDRESS:_____________________________________________________ TELEPHONE NUMBER (S) __________________________________ IV. EDUCATION BACKGROUND NAME OF SCHOOL CERTIFICATION YEAR OF COMPLETION V. PROFESSIONAL QUALIFICATIONS( FOR PRE-QUALIFIED APPLICANTS) NAME OF QUALIFICATION YEAR OF COMPLETION INSTITUION OR BOARD VI. APPLICANT’S SERVICE PARTICULARS (FOR IN –SERVICE PPLICANTS) CURRENT EMPLOYER:____________________________________ DEPARTMENT/SECTION: ________________________________ POSITION: ________________________________________ EMPLOYEMTN ADDRESS: __________________ TELEPHONE NUMBERS: ______________________________________ E- MAIL ADDRESS_______________________________ V. SPONSOR’S CERTIFICATION (IF ANY) THE UNDERSIGNED (NAME OF SPONSOR): _____________________ AND ON BEHALF OF (NAME OF AGENCY OR ORGANIZATION): ____________________________________________________ AND IF ACCEPTED, UNDERTAKE TO PAY FOR ALL THE EXPENSES RELATED TO THE COURSE SIGNATURE:_________________ DATE: __________________ (OFFICIAL STAMP) VI. APPLICANT’S DECLARATION I CERTIFY THAT ALL THE ABOVE INFORMATION IS CORRECT AND TRUE TO THE BEST OF MY KNOWLEDGE AND BELIEF. FULL NAME OF APPLICANT:_____________________________ SIGNATURE: _________________________ DATE: ___________ Further information may be obtained in person or in writing from: The Coordinator, Week-end College Shaaban Robert Street IFM Block A, Ground Floor, Room G.20 P.O. Box 3918, Tel.(022) 2112931-4 Fax (022) 2112935 DAR ES SALAAM
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