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A password will be e-mailed to you.

COLLEGE NAME & CONTACTS

………………………………………………………………….

Year/LevelOn CampusOff Campus
Student DetailsClearance Reasons
Name of the Student……………………………………………Transfer 
Registration Number…………………………………………..Completion 
Course of Study: ………………………………………………..Withdrawal 
SNDEPARTMENT

(See the relevant checklist of items to be cleared attached)

CLEARING OFFICERSIGNATUREDATEREMARKS
1 

…………………..

 

 

2 

…………………..

3 

…………………..

4 

…………………..

5 

…………………..

6 

…………………..

7HOD (Academics)

 

8Practical and IPT Coordinator

 

9Library

 

 

 

10Warden’s Office

 

 

 

11ESISSO

 

 

 

12HOD (Finance & Administration)

 

13Principal’s Office

 

If there is an item not surrendered or debt not paid please mention it in the remark’s column. You can use additional plain paper signed by both parties to give the required details

ELIGIBILITY FOR CAUTION MONEY REFUND

The student is eligible/not eligible for the refund (Cancel inappropriate)

If not eligible please explain: ……………………………………………………………………………………………

……………………………………………………………………………………………Student Bank Account Information

Name…………………………………………………………………………………

Account Number………………………………Bank Name…………………………….

Student’s Signature……………………… Phone……………E-mail…………………

 

NOTE:

  1. Original dully filled clearance form must be submitted to the administration office
  2. A student must retain a copy of the dully filled clearance form for future reference
  3. This form should be associated with the checklist of item to be cleared from by the student per each department.
  4. An accountant should convert not cleared items to current market value price and be mention in the section of “For internal use only” below

***************** “For office use only” ********************

(Tick in the box at the right OR supply the necessary information)

 

This student is cleared from all institute items/ debts.

 

 

 

 

This student is not cleared from all institute items/debts.

Items damaged or dept own value to TZS. …………………………

 

 

 

 

Prepared by ………………………Designation ……………………Date …/../…

Approved by ………………………Designation ……………………Date …/../…

STUDENT CLEARANCE FORM

Taarifa:

Tunaweza kutoa huduma hii kwa gharama kidogo, huduma yenyewe yaweza kuwa ni ushauri, mafunzo au kufanya kazi husika. Tunatoa pia huduma ya masafa kupitia chat, email, mitandao ya kijamii nk

We offer services at substantial low cost. The service are consultation, training and doing personally the actual work. We also offer services remotely through chat, email, social media interfaces etc

__________________________________________________
We offer but not limited to the following:
Business Office Documents Development, Company Registration, Business Plan Development, Curricula Development for colleges, Office Digitization Consultancy, Online Presence and Marketing Consultancy, Leadership and Management Consultancy, Constitution Development  and much more

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Fomu ya Kiswahili


About The Author

Lemburis Kivuyo is a Busi­ness, IT and Com­mu­nity Related Project Consultant. Specialized in Business Establishment, Leadership training, Online Marketing, Small groups and teams leadership and management, Curriculum Development, Constitution development and much more.

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