Best Medical Universities in Zambia to Study Medicine

STUDY CENTER - APPLICATION FORM

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Program Details

Full name of Institution *

Year of Incorporation *

Incorporation Certificate

Address*

Country*

Name and address of any branch or associated institutions (if applicable) and whether they will also offer the courses

Branch 1

Branch 2

Branch 1 Photo

Branch 2 Photo

Telephone *

Fax

Email*

Principal/Directors Name *

Institution Established Date *

Are you registered with your local Ministry of Education? *

Yes No

Have you operated this institution under any other name? *

Yes No

Current Course Details

List here other courses that are offered at your institution and the approximate number of students enrolled each year. Please indicate whether the students are full-time or part-time *

List any professional or examining bodies which recognise your institution as a teaching centre. State whether this is an internal or external courses centre *

List any Courses held at your institution with the approximate numbers sitting at any one time. (These should be Courses of recognized examining bodies.) *

Course

Students Per Annum

Facilities & Equipment

Number of lecture rooms (capacity: 25 students) Please list any teaching aids (eg Overhead Projector, audio facility *

Number of large computer rooms (capacity: 16 students +) Please list hardware/software provision *

Programs Interested

Programs am interested to offer in my Center *

BBA MBA MPH

Staff Details

Please give details of the member of staff who will be the academic head of the programmes you wish to run.

Staff Name

Qualifications

Years with Institution

How are they employed?

Full-time Part-time

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