SLP Application Form - STAFF

This application form is for staff of Nelson Mandela University.

Kindly complete the form below if you have obtained approval from your line manager and would like to apply to the Department of Applied Language Studies (DALS) and Human Resources Development (HRD) to complete a specific SLP.

You will be required to attach a copy of your ID/passport.

Kindly wait for the outcome of your application before attending any sessions.

Thank you.

Title:

First Names:

Surname:

Staff Number:

Gender:

Marital Status:

Home Language:

Age:

Cell No.:

Additional Contact No.:

Email:

Postal Address:

City/Town (current residence):

Race (for statistics):

Dietary Preference (if any):

ID or Passport Number:

ID or Passport Copy:

Upload:

School Leaving Date:

Level of Education:

Current activity (occupation):

Department/Faculty:

Short Course:

Have you obtained permission from your line manager to attend this course?:

Why would you like to study this course?:

Do you have any special learning requirements?:

Do you have access to the internet after hours?:

Comments:

Complete:

Enter security code: