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4x4 photo - University of Buea

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UNIVERSITY
OF BUEA
REPUBLICOF CAMEROON
REPUBLIQUE
DUCAMEROUN
UNIVERSITE
DE B'IEA
HIGHERTECHNICALTEACHERS'TRAINING
coLLEGE (H.T.T.T.C)
KUMBA
ECOte N onueLE s UPERIEURE
(ENSET)KUMBA
D'ENSEIGNEMENT
TECHNIQUE
APPLICATION
Peace-Work-Fathedand
Paix-Travail-Patrie
FORM / FORMUL./IIRN'DE DEMANDE D' INSCKIPTION
COMPETITIVE ENTRANCEEXAMINATION INTO YEAR THREE OF THE FIRST CYCLE
HIGHER TECHNICAL Tf,ACHERS' TRAINING COLLEGE (H.T.T.T.C),KUMBA, UNIVERSITY OF BUEA
CONCOARSD'ENTREE EN TROISIEME ANNEE DUJEELIIEEE.CICLE DE L'ECOLE NORMALE SU
D'ENSEIGNEMENT TECHNIQUT: (ENSET), KI]MBA, IJNIVERSITE DE BIJEA
2rr1fr$HSSTON
1) Form No
4X4
Bank Receipt N'.
Formulaire no
RicCpissd bancaire no,
Bank Details: Pay to Ecobank,
Name:HTTTC,Kumba;
Acc.Number:0090222623249501
A dt esse bancairc: Ec obank,
Nom du compte:ENSEI',Kumbn:
Nr.rm6rortecompte:0090222623249501
PHOTO
PERSOI{AL DATA'/ r JfjOfrlMrlItOft S,DERSOIVIVELLES
2) Name I Noms:
(As on birth ceftifrcate / Comme dans I'acte de nais::ance)
3) Dateof birth:
4) Placeof birth:
_/19-
Lieu denahsanc::
Dde de naissance:
5) Sex:
8) Email
7) Tel:
6) Nationality:
Sexe:
NationalitC:
TCL :
I Counieli
-10)
Divisiou:
9) Region of origin:
Rdgiond'origine:
lJapattehe",i:
ll) Sub-Division:
Atondissement:
12) Mariial status:
Etot civil:
l3) Religion:
Religion:
f4) Dept. chosen:
DCptChoN:
l5) Option chosen:
Optionchoisle:
17)Duration of Studies:(Year Started
Durde desitudes; ( Annced'entfte
16) Name of University;
NomdePUniversitd
Year of Completion)_
A nnCe obtention Licence)
18) Class or Average of HND Obtained
Moyenneobtenue(BTS):
19) Centre where application was dropped:
Cerrrrcdedqil da dossicr:
20) PreferredEntranceExaminationCentre:
Cenfie d'samen
Choisi:
21) Preferred Language for Examination: (select
onlyone)
LangueprdlerCe
pour le concoars:( cocherunesealecase)
English:
.4 nglais.
22) SPECIAL APPLICANTS I CANDIDATSSPECIAUX
Which of the following disabilitiesdo ycu havel |,1orur"de la ddliciencedontvoussouffrez.
Visual n
Visuelle"
HearingI
-
Auditive
SReech
fl
L
Parole
Physical
I
Physique
Other(Specifu)
Autres (Prdciser)
French:
Frangais:
Paper I (Major) 3 hrs Coef. 4
Department
Ddpartement
option
option
3 hrs
I (Majeure)
Epreuve
lfY
cocHv
Coef. ,l
Civil Engineeringand ForestryTechnics
Ghnie civil d techniqaesforestibes
/
BuildingConstruction
/
BuildingConstruction
Bdtiments
Bdtiments
Topography
Topography/
/
Topr:graphy
Topographie
Topographie
f,lectrical and Power Engineering
GCnieCledrique
Iechanical Engineering
TCniemCcanique
iocialEconomyand Family Management
lconomie socialeet familiale
Electronics /
Electronique
Electronique
Automobilemechanics
Mdcaniqueautomobile
Automobilemechanics
Mdcaniqueautomobile
Home Economics /
Home Economics/
sociale
3 h Coef.2
2 (MineurQ
Epreuve
General Knowledge / Culturegentrale
Generaf Knowledge / Culturegcncrale
Topographie
Electronics /
Economie
Pap.r 2 (Minor) 3 hn Coef. 2
Economie
General Knowledge / Culturegindrale
General Knowledge I Culturegdnirale
ieneral Knowledge I Culturegcndrale
sociale
lndustrialComputing/
ComputerSciences
GdnieInform&iqae
lndustrialComputing/
I nfor matique Indu str ieI Ie
AdministrativeTechniques
and
InformationManagement
(lMC) /
Communication
M anapement de l' inform ation
et de la communicdtion (MIC)
Generaf Knowledge I Culturegdncrale
Techniquesadninistrutives
Management
Information
(lMC)/
andCommunication
Management de
l'infofmation et de la
cokmunication (MIC)
ManagementSciences
/
Accountancy
/
Acoountancy
General Knowfedge I Culturegdncrale
Sclences de gestion
Comptabilitd
Comptabilitd
Tourismand HospitalityManagement
Tourism/
'l'ourism
/
Tourisme et H^tefiefie
Tourisme
Tourisme
General Knowledge f Culturegdnirale
I nform atique I ndustr i eIIe
General Knowledge I Culturegdncrale
DECLARATION/DECLARATION
I/Je,
herebydeclarethatalltheinformationgiveninthisformiScorrecttothebestofmyloowledge.Anyfalse
beingconsideredforadmissionto,oriontinuingwithanycourseofstudyintheUniversityofBuea'lshallacceptasfnalthedecisionoftheUniversitythreFd
hogrammeof study.
soussigndrecomaisavoirfoumidesinformationsexact
cationauprocesSusd'admissionoulapoursuitedesdtudesil'UniversitddeBuda.Jem,engagedaccepter
grammed'€tude.
Signature"
Note: Form can be downloaded from our website: wtltrtt.ubuea-cm
NB: Ceformulairepeut AftetdldchargdsurnotresiteInternet: www.ubueo.cm
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