Skip to content
267 5441070 / 72881025
STAFF / STUDENT LOGIN
HOME
APPLY ONLINE
CLASSROOM
Facebook
KSDACON
SID news
EGWHITE BOOKS
esda
ABOUT US
Application Form
Please enable JavaScript in your browser to complete this form.
Please enable JavaScript in your browser to complete this form.
CLOSING DATE
*
30/04/2025
30/04/2025
Year
*
Program Applying For;
*
Diploma in General Nursing
Midwifery
Short Course
Distance Learming
Block Release
SECTION A – PERSONAL DETAILS
PERSONAL DETAILS
Full Name
*
First
Middle
Last
Maiden Name
(Applies to Married Females – Your Prevous Surname before you got Married)
Gender
*
Male
female
Date of Birth
*
Place of Birth
*
Marital Status
*
Married
Single
Number Of Children
*
Nationality
*
Email
*
Email
Confirm Email
Nationality ID No:
*
SECTION B – ADDRESS
Place of Stay
Ward
*
Postal Address
*
House No.
*
Mobile Phone No.1
Mobile Phone No.2
SECTION C – NEXT OF KIN CONTACT DETAILS
NEXT OF KIN 1
Name
*
First
Middle
Last
Relationship
*
Postal Address
*
Mobile Phone No.1
*
Mobile Phone No.2
Tel No.
Email
*
NEXT OF KIN 2
Name
*
First
Middle
Last
illness Completion
Relationship
Postal Address
*
Mobile Phone No.1
*
Mobile Phone No.2
Tel No.
Email
*
SECTION D – EDUCATIONAL BACKGROUND
Educational Level
*
Senior School
Teartiary
School Name
Certificate Obtained
BGCSE
IGCSE
Professional Certificate
Year of Completion
Professional Certification
(Indicate your professional certificate – if applicable)
BGCSE Subjects
*
English language
Mathematics
Physics
Chemistry
Biology
Geography
Setswana
History
Commerce
Business Studies
Accounts
Computer Studies
Please indicate only Subjects written Certificate
Qualifications Obtained
English language
*
A
B
C
D
E
F
G
Mathematics
*
A
B
C
D
E
F
G
Physics
*
A
B
C
D
E
F
G
Chemistry
*
A
B
C
D
E
F
G
Biology
*
A
B
C
D
E
F
G
Points Obtained
*
Name & Address of School Last Attended
*
Reference
*
Give two names of persons who know you very well (not related to you)
SECTION E – HEALTH STATUS
Have you ever had any Serious Injuries / illness that might interfer with your training?
*
Yes
No
If "YES", please explain;
SECTION F – LEGAL OFFENCES
Have you ever been convicted of any Criminal Offences in Botswana or elsewhere
Yes
No
If "YES", Please Explain;
SECTION G – POST BASIC PROGRAMMES
To be completed by Applicants applying for Post- Basic Programmes.
Professional Education
EMPLOYMENT INFORMATION
Have you ever been employed? (Please Select to indicate)
Yes
No
If Yes, Please Select
Permanent
Temporary
Ministry / Non Government Organisation
Department
Name of Health Facility
Address
Position Held
Years of Service
Telephone
Nursing and Midwifery Council of Botswana (NMCB) Reg. No
Name of Sponsor
Contact Address
Telephone
SECTION H – CERTIFIED ATTACHMENTS
Omang
Certificates
Transcript
Two References
Professional bodies Registration Certificates
Tirelo Sechaba / Exemption Certificates
To be submited by all Applicants
Apply Now
