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TELEPHONE: 3928351
FAX: 3928382
TLOKWENG COLLEGE OF EDUCATION
PRIVATE BAG T01
TLOKWENG
APPLICATION FORM FOR DIPLOMA IN PRIMARY EDUCATION
For Official Use: Application Number: ………………………………… CLOSING DATE: 28th April 2021
Admission Year: 2022/23
1. Surname: …………………..………………….. Other Names: ……..………………………………………………….
Male: ………… Female: ………… Date of Birth: …………………………………… Age: ………………
2. Citizenship: …………………………………… Omang/Passport No: ………………………………………………
3. Marital Status: Married/Single/Divorced Other: …………………………………………
4. Home Address: ………………………………………………………………………………………………………………
Tel No: …………………………………………… District: ………………………………………………………………
5. Address for Reply: …………………………………………………………………………………………………………
Cell No.: ………………………………… E-mail Address: ……………………………………………………………
6. Name of last Senior Secondary School attended: …………………………………………………………………
Year of Completion: ………………………
Who financed your education at Senior Secondary School?
Parent/Guardian Social Services Department Other (Specify) ……………………
7. Academic Qualifications: BGCSE POINTS: ……………… COSC POINTS: ……………………………
Other Exam(s): ……………………………………………… Year of Completion: ……………………
8. Please specify any other qualifications/training/Tirelo Sechaba?
………………………………………………………………………………………………………………………………………
9. SUBJECT RESULTS: In each box put the letter grade that you obtained in the subject.
English English History Geography Development Commerce Setswana Agriculture Religious
Literature Studies Education
Maths Additional Double Biology Chemistry Physics Art Food & Fashion& Statistics
Maths Science Nutrition Fabrics
Other(s): ………………………………………………………………………………………………………………………….
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10. Teaching Experience: Yes/No ………… If “yes” type of School: ………………………………………………
Standard/Level taught: …………………… No. of Months/Years:……………… TSM No: …………………
11. Any Other Work Experience: ………………………………………………………………………………………………
Number of Months/Years: …………………………………………………………………………………………………
12. What work or Study are you currently doing: ………………………………………………………………………
Name of Employer/Institution: ……………………………………………………………………………………………
13. SUBJECT OPTION
CHOICES OF AREAS OF SPECILISATION.
Mathematics and Science
English and Setswana
Religious Education and Social Studies
Practicals: Choose one from part ‘a’ and one from part ‘b’
a. Agriculture b. Home Economics
Physical Art
Education Music
Which subject option would you like to specialize in? [Select from the above areas of
specialization].
First Choice: ……………………………………………and ………………………………………………………
Second Choice:…………………………………………… and ……………………………………………………
Third Choice:……………………………………………… and ……………………………………………………
14. Have you ever been convicted of any criminal offence? Yes: No:
15. Do you have any of the following: YES NO
Social Disadvantage
Medical Problem
If “YES” Specify. (NB: Provide a supporting document if you are under Social Services
Department care):
………………………………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………………………………
16. Do you have any disability? Yes No
If “YES” Specify
………………………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………………
17. Person to be contacted in case of emergency: ……………………………………………………………………
Relationship: ……………………………………… Tel/Cell No: ………………………………………………………
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Address: ………………………………………………………………………………………………………………………
18. INFORMATION FOR PREVIOUS EDUCATION
Have you attended any Tertiary Institution before? (Tick) Yes: No:
Name of Institution: …………………………………………………………………………………………………………
Programme: ………………………… Duration of Programme: ……………… Date: …………………
Did you complete the programme? (Tick) YES NO
If the answer above is No, how long did you attend the programme and why didn’t you
complete the programme?
Duration: ……………… Reason: ……………………………………………………………………………………
Have you ever been granted a student loan by Ministry of Education? Yes: No:
19. SPONSORSHIP INFORMATION
How are going to finance your College tuition? (Tick)
Government Sponsorship: Private Sponsorship:
20. FOR INTERNATIONAL APPLICANTS ONLY:
Are you or your parents/guardian resident in Botswana? (Tick)
Yes: No:
If yes, please provide proof of resident status by attaching a copy of each of the following: Tax
Certificate, payslip and resident permit for your parents/guardian
21. Declaration by Applicant:
All the information given by me is true to the best of my knowledge. I am aware that any false
statement will nullify my application.
Name: …………………………………………………………… Signature: …………………………………………
Date: ………………………………………
Note:
The following must accompany your application: at least 2 references, certified copy of Omang or Passport
( international applicant only), certified copy of residential permit (international applicant only), Social
Services Department letter (only for those assisted by Social Services Department), certified copies of
academic and professional certificates and any other relevant document.
