MEMORANDOM

TO: TanzaniaProgramStudents,Fall2016 FROM: EmilyGaul,AssistantDirectorDATE: March1,2016RE: UDSMForms___________________________________________________________________________Please find the attached forms to complete for your UDSM registration.Please print off the forms single‐sided ‐ double sided copieswill not beaccepted.Foreachform,thereisamemothatoutlineswhatneedstobedone. ThefollowingformswithpassportphotosareduetomebyMay1,2016: ResidencePermitApplication TanzaniaImmigrationDepartment–ResidencePermitDataSheet UDSMApplicationForm UDSMStudentRegistrationForm Resume Copyofyourpassport 12Passportsizephotos(inadditiontothepassportphotosneeded

oneachform)(Pleaseconsiderusinganonlineprogramorphotoeditortoprintthese–itisamuchcheaperoptionthangoingtoWalgreensbutbesuretheyarethecorrectsizeandprintedonphotopaper.)

UDSMMedicalFormB(providedinaseparatePDF) ACMReportofMedicalHistoryForm(providedinaseparatePDF)

Itisessentialthatallformsarecompletedcorrectlyandsubmittedon‐time. If forms are not turned in on‐time you may not be able toparticipate intheprogram. Again,allof these formsaredue tomeonMay1.If you have any questions, please contact me either by email(egaul@acm.edu)orphone312‐561‐5919.

ApplicationforFirstGrant/ReplacementofResidencePermit‐Tanzania

Thefollowingareinstructionsforcompletingformsyourresidencepermit(whichwillbeissuedonceyouareinTanzania).Pleasereadthismaterialcarefully,asyoureligibilitytostudy at UDSM depends on the suc c e s s f u l c o m p l e t i o n o f t h e s e f o r m s . A f t e r y o u h a v e completed theenclosed forms,please send them toACMno laterthanMay1.Pleasefindbelowalistofmoredetailedinstructions.

Pleaserefertotheexampleprovidedbelow.

YoudoNOTneedtoattachfivephotographstothisapplication.SimplypasteONEphotographintheupperrighthandcorner.

Do NOT fill out any information past Part 1. Please leave the rest of theapplicationblank.

Please send your completed application to the ACM byMay 1. I f y o u h a v e a n y questions,pleasefeelfreetocontactmeategaul@acm.eduor312‐561‐5919.

Sendthehardcopyto:

AssociatedCollegesoftheMidwestAttn:EmilyGaul11E.Adams,Suite800Chicago,IL60603

PASPHOTO

OAPPLI

HETHE UNITED REPUBLIC OF TANZANIA

Dossier Number ……………………………………

APPLICATION FOR FIRST GRANT/RENEWAL OF RESIDENCE PERMIT CLASS A/B/C (THE IMMIGRATION ACT, 1995)

IMPORTANT:

Applications for Residence Permit Class A and C should be forwarded to the Director of Immigration SP.O box 512, Dar es Salaam. Applications for class B (employees) should be forwarded to the DirectoImmigration Services through the Labour Commissioner, P.O Box 9014, Dar es Salaam.

Five photographs should be attached to application forms.

PART 1 – PARTICULARS OF APPLICANT I HEREBY APPLY FOR FIRST GRANT/RENEWAL OF RESIDENCE PERMIT CLASS…………………

1. Full name MR/MRS/MISS: ............................................................……………………….…………

2. Marital Status……………………………………………………………………………………….……

3. Home Address: ........................................................................……………......……………………

4. Address while in Tanzania…………………………………………………………………...…………

5. Place of Birth:..............................………..........………. Date of Birth: ………….....………….……

6. Nationality: ............................................................……………………………………………………

7. Passport No: ....................…....... Date of Issue: ..………................... Place of Issue………….…

8. Height………….…………… Colour of eyes……….…………..………. Colour of hair……...………

9. Academic qualifications held…………..……………………………………… Photocopies of Certi

or other proof should be attached.

10. Profession/Occupation/ for self employed applicants state specifically what type of business yo

carrying on…………. ...............................………………………...………......................................

11. (a) Place of intended Residence in Tanzania: Region: ............……....….District: .…………....…

Area ……………………………………….Street…......……………………………………….………

(b) Place of Work in Tanzania: ....……………........…............………….. Region...........…………

District………………………….…………………………………………………………….……….……

12. Application for Residence Permit will be required to execute one of the following conditions:

(1) General Security Covenant

(2) Bank Bond (U$ 1,000)

(3) Cash Deposits (U$ 1,000)

13. Particulars of any previous application for residence permit to Tanzania stating whether or not

have been granted or refused…………………………..………………………………………………

DECLARATION 14. I …………………………………………………THE APPLICANT, HEREBY DECLARE THAT TH

AFOREGOING ARE CORRECT IN EVERY DETAIL.

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

PART II – PARTICULARS OF ACCOMPANYING FAMILIES To be completed only by applicants who wish their non Tanzanian wives and children under 18 ye

age to reside with them in Tanzania.

Full Name Relationship to Applicant Date of Birth

………………………………. ……………………………………………………. ………………………

………………………………. ……………………………………………………. ………………………

TIF. 1

TE GRAPH F CANT RE

ervices r of

………..

………

………..

……….

….…….

……….

………

………

……..

ficates

u are

........….

…….....

……......

…..……

………

they

……..

E

………

ars of

……….

……….

………………………………. ……………………………………………………. ……………………………….

………………………………. ……………………………………………………. ……………………………….

………………………………. ……………………………………………………. ……………………………….

………………………………. ……………………………………………………. ……………………………….

PART III – EMPLOYMENT INFORMATION – (To be completed by Employer if Applicant seeks to take up or continue with specific employment in Tanzania).

NOTE: It is the Government’s policy that the economy of Tanzania should be manned by trained and

competent citizens. Resident Permit (or renewal therefore) for employment in Tanzania are issued to non-

citizens with skills not available at present in Tanzania labour market only on the understanding that

effective training programmes in service or other wise are undertaken with a specified period to produce

trained citizens competent to replace them. For further information contact the appointment Bureau of the

Ministry of Labour and Manpower Development, Dar es Salaam.

15. Name of Employer………………………………………………………………………………………………

16. Industry…………………………………………………………………………………………………………..

17. Total number of your employees

Citizen……………………………… (a) Skilled…………………………. (b) Unskilled……………………

Non Citizen………………………… (a) Skilled………………………… (b) Unskilled

18. Job title…………………………………………………………………………………………………………….

19. Job description (Give a brief description of what an individual holding this Post is required to do in

your undertaking…………………………………………………………………………………………………..

20. Experience and other requirements (state estimated minimum period needed for a newly qualified

worker to perform independently upon completion of the necessary training e.g. “immediately after

one year close supervision etc.”

21. What efforts have you made to obtain job for the citizen?……………………………………………………

………………………………………………………………………………………………………………………

22. Do you presently operate a scheme of in-service training or participate in any Government sponsored

scheme of education programmes operated by any approved higher education/technical Institution to

get a Tanzanian for the post…………………………………………………………………………………….

………………………………………………………………………………………………………………………

………………………………………………………………………………………………………………………

23. IMPORTANT TO NOTE:

(a) Employees will be required to submit return on Employment of Non-Citizens (TIF 19 to the

Director of Immigration Services before 31st March yearly.

(b) State when you lastly submitted your Returns on Employment of Non-Citizens to this office.

Date…………………… 20……….. ……………………………………………….

Signature of Employer with Official stamp

PART IV – (FOR OFFICIAL USE ONLY): 24. Comments of the Ministry of Labour and Manpower Development……………………………………..

………………………………………………………………………………………………………………….

………………………………………………………………………………………………………………….

Date …………………………… 20…… …………………………………………………………

Labour Commissioner

25. Action by Immigration Division………………………………………………………………………………

………………………………………………………………………………………………………………….

………………………………………………………………………………………………………………….

Date…………………………………… ………………………………………………………….

Director of Immigration Services

TanzaniaImmigrationDepartment–ResidencePermitDataSheet

ThefollowingareinstructionsforcompletingtheresidencepermitdatasheettoaccompanyyourresidencepermitapplicationPleasereadthismaterialcarefully,asyoureligibilitytostudy at UDSM depends on the suc c e s s f u l c o m p l e t i o n o f t h e s e f o r m s . A f t e r y o u h a v e completed the enclosed forms,please send them toACMno laterthanMay1.Pleasefindbelowalistofmoredetailedinstructions.

Attachonepassportsizephotototheleftcorner USECAPITALLETTERSwhenfillingouttheform Nonottickanyboxesinthe“appropriateclass”section

PartI–ParticularsastoEmployee1. Yourfirstname2. Middlename3. Lastname4. Leaveblank5. Dateofbirth6. Age7. Gender–MorF8. Placeofbirth–City,State,Country9. Homeaddress–street,city,state,country10. Passportnumber11. Dateofpassportissue12. Dateofpassportexpiry13. Passportcountryofissue14. Nationality15. Countryoforigin

PartII–ProfessionalInformation16. Jobtitle/occupation–Student17. Profession–student18. AcademicQualifications–UniversityStudent19. RegistrationBoard–leaveblank20. TermsofEmployment–leaveblank

PartIII–Dependents‐LeaveBlank

PartIV–ParticularsastoInstitution/Individual25. Institution–UniversityofDaresSalaam26. Location–DaresSalaam27. PostalAddress–LinksOffice,UDSM,Box35901,DaresSalaam28. Placeofwork–leaveblank29. Placeofresidence(inTanzania)–UniversityofDaresSalaam30. Industry/Sector–University32. InvestmentSector–leaveblank

33. Telephonenumber–leaveblank34. Mobilephonenumber–leaveblank35. Emailaddress–enteryouremailaddress

PartV–DeclarationbyInstitution/Individual36. Signanddate

Please send your completed application to the ACM by May 1. I f y o u h a v e a n y questions,pleasefeelfreetocontactmeategaul@acm.eduor312‐561‐5919.

Sendthehardcopyto:

AssociatedCollegesoftheMidwestAttn:EmilyGaul11E.Adams,Suite800Chicago,IL60603

PASSORT SIZE

WHITE BACKGROUND Tick the appropriate Class CLASS

1st Grant

size 3.5cm x 4.5cm 2nd Grant

Official stamped Returned Grant

Replacement

USE CAPITAL LETTER

dd mm

6 Age GENDER

……………………………………………………………………………………………………..

……………………………………………………………………………………………………..

dd mm yyyy dd mm

EXPIRY DATE

PASSPORT NUMBER:

A B

HOME ADDRESS

C

TANZANIA IMMIGRATION DEPARTMENT

ALL INFORMATION IS MANDATORY AND WILL APPEAR ON YOUR RESIDENCE PERMIT

serial No…………………………………..

3 SURNAME/LASTNAME

1 FIRST NAME:

12DATE OF ISSUE:

SECOND NAME:

11

RESIDENCE PERMIT DATASHEET TO BE COMPLETED BY INSTITUTION/INDIVIDUAL

yyyy

7

9

OTHER NAMES:

8 PLACE OF BIRTH:

2

yyyy

10

PART I - PARTICULARS AS TO EMPLOYEE

DATE OF BIRTH:

4

5

F/M

1 of 2

EXPIRY DATE

……………………………………………………………………………………………………..

JOB TITTLE/OCCUPATION ……………………………………………………………………………………………………….

PROFESSION ……………………………………………………………………………………………………….

(Master,Degree,Dip or Certificate)

REGISTRATION BOARD ………………………………………………………………………………………………………. e.g CRB,NBAA,NMMB e.t.c

DATE OF BIRTH

…….……………………………………………………………TERMS OF EMPLOYMENT:

15

……………………………………………………………………………………………………..

12

PART III - DEPENDANTS

DATE OF ISSUE:

COUNTRY OF ORIGIN:

11

16

PART II - PROFESSIONAL INFORMATION

17

NATIONALITY14

13 COUNTRY OF ISSUE:

……………………………………………………………………………………………………..

RELATION

18

19

20

ACADEMIC QUALIFICATION:

SURNAMESECOND NAMES/NO.

21

22

23

24

FIRST NAME PASSPORT NUMBER

………………………………………………………………

NATIONALITIES

1 of 2

PART IV - PARTICULARS AS TO INSTITUTION /INDIVIDUAL (As written on TF1 )

……………………………………………………………………………………………………..

…………………………………………………………………

e.g. Mining

LARGE MIDDLE: SMALL OTHERS (Specify) …………………..

……………………………………………………………………………………………………..

Do HEREBY SOLEMNLY and sincerely declare that to the best of my knowledge and belief the

particulars stated in Part I,II,III & IV of this Data sheet are true, and in event of my application

being granted, I undertake to abide by Immigration laws and the Laws of United Republic of

I,…………………………………………………………………………………………………………………………………………………………………………………36

PLACE OF WORK

INSTITUTION :

MOBILE PHONE NUMBER

PLACE OF RESIDENCE (in Tanzania)

INDUSTRY/SECTOR

TELEPHONE NUMBER

……………………………………………………………………………………………………..

35 E-MAIL ADDRESS

34

28

29

POSTAL ADRESS

25

LOCATION :

32 INVESTIMENT SCALE:

……………………………………………………………………………………………………..

27

PART V - DECLARATION BY INSTITUTION/INDIVIDUAL

33

30

26

2 of 2

Signature of Institution/Individual with Official stamp

……………………………………………………………………………………………………..

NAME AND RANK OF OFFICER ATTENDED HEADQUATER/REGION SIGNATURE

……………………………………………………………….. ……………………………………. ………………………………

PART VI - FOR OFFICIAL USE ONLY

Declared at ……………………………………………… this ………………………… day of ………… 20 ………………

being granted, I undertake to abide by Immigration laws and the Laws of United Republic of

Tanzania.

38

37 DOSSIER NUMBER:(DN)

…………………………………………………………………

2 of 2

UniversityofDaresSalaamApplicationFormforAdmissionforShort‐TermStudent

The following are instructions for completing forms for enrollment at the University of Dar esSalaam. Please read thismaterial carefully, as your eligibility to study atUDSMdepends on thesuccess fu l complet ion o f these forms . A f ter you have completed the enclosedforms, please send them to the ACM by May 1. Please find below a list of more detailedinstructions.

UniversityofDaresSalaamApplicationforAdmissionforShortTerm/OccasionalStudent:

CompletethefollowingnumbersusingBLOCKCAPITALS:

1. FamilyName:yourlastnameOthernames:yourfirstnameGender:MorFDateofBirth:d/m/yearNationality:forexample,USA

2. EntryQualifications:YoudoNOTneedtoincludeacopyofyourtranscript.Undergraduateyear:junior/seniorCourse:pleaselistyourmajorOtherQualifications:leaveblank

3. ApplicantContactAddress:pleaseuseyouhomeaddress4. FinancialsponsorforUniversityfees:leaveblank5. Areyouapplyingasashort/termoccasionalstudent:alreadyfilledout6. Choiceofcoursesanddurationofstudy:leaveblank7. Signanddate

Whenyouarefinishedfilling‐outtheblankapplicationform,papercliptwopassport‐sizephotosovertheboxintheupperright‐handcorner.

PleasesendyourcompletedUniversityofDaresSalaamformstotheACMbyMay1.Ifyouhaveanyquestions,pleasefeelfreetocontactmeategaul@acm.eduor312‐263‐5000.

Sendmaterialsto:

AssociatedCollegesoftheMidwestAttn:EmilyGaul11EastAdams,Suite800Chicago,IL60603

University of Dar es Salaam Two photos APPLICATION FORM FOR ADMISSION FOR SHORT-TERM/OCCASIONAL STUDENT

1. Family Name………………………………Other names……………..…………………………

Gender…….Date of Birth…………………….… Nationality………………….……….………

2. Entry Qualifications: Please attach transcript

i) Undergraduate year …………………….……... Course …………………..……………..

ii) Other qualifications…………………..…………….……….…..………………….…………

3. Applicant’s Contact Address:……………………………………………………………………

……………………………………………………………………………………………………….

4. Financial sponsor for University fees (enclose guarantee letter)

5. Are you applying as a short-term/occasional* Student? ……………………………..……..… one year/ one semester (Please specify) 6. Choice of courses and duration of study (specify):

Course: i) B.A / B. A. Education ii) B. Sc. Gen./ Geology/ Computer/ Electronics/Education iii) B.Sc. Eng. iv) B.Com. v) LL.B. (Laws) vi) Faculty of Informatics and Virtual Education (FIVE) vii) Faculty of Aquatic Sciences and Technology (FAST) viii) Faculty of Civil Engineering and Built Environment ix Faculty of Electrical and Computer Systems Engineering x Faculty of Mechanical and Chemical Engineering

7. Applicant’s signature:………………………………………...Date:……………………………. 8. Sending College/University recommendation/verification/remarks

………………………………………………………………………………………………………

Name ………………………….….……………………….…..,….…. …………………..…….…

Address……………………….……………………………………………………………………..

………………………………. …….………………………………………………..………………

Signature and official stamp………………………………………………………………………

*Short-term studentship: 1 academic year. Occasional studentship: one semester.

UniversityofDaresSalaamStudentRegistrationForm–DegreeProgrammes

ThefollowingareinstructionsforcompletingformsforenrollmentattheUniversityofDaresSalaam.Pleasereadthismaterialcarefully,asyoureligibilitytostudyatUDSMdependson the successful completion of these forms. After you have completed the enclosedforms,p l e a s e s e n d t o t h e A C M b y May1. P l e a s e f i n d b e l o w a l i s t o f m o r e d e t a i l e d instructions.

UniversityofDaresSalaamStudentRegistrationForm:Complete thehighlightednumbersusingBLOCKCAPITALS:1,2,3,4,5,6,7,8,11,12,18a,19,20a,20b,20c,21a,21b,21c,and24.Whenyouarefinishedfilling‐outtheblankStudent Registration form, staple a passport‐size photo (does not need to be black andwhitephoto)overtheboxintheupperright‐handcorner.

PersonalResume:PleasesendtotheACMacopyofyourpersonalresume.Yourresumedoesnotneedtobeextensive.Aone‐page,simplifiedversionisfine.

Please send your completed University of Dar es Salaam forms and a copy ofyour resume to the ACM by May1. I f you have any ques t ions , p l ease f ee l f ree to contac t me a t egaul@acm.eduor312‐263‐5000.

Sendmaterialsto:

AssociatedCollegesoftheMidwestAttn:EmilyGaul11E.Adams,Suite800Chicago,IL60603