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SHORT COURSE TRAINING APPLICATION/BOOKING FORM To apply please fill in and return to cpd@mua.ac.ke, skamau@mua.aca.ke

Course Details Course Title: Period From:

To:

Applicant’s Details Surname: First Name: Position: Organization:

Prof./Dr./Mr./Mrs./Ms./Other: Other Names: Department:

Address: Telephone: Email:

City: Mobile: Website:

Postcode:

Education/Training Background Highest level of Formal education: Highest level of Professional education: Area of specialization: Objectives for attending this course: _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ Applicant’s Signature: _______________________

Date__________________________________________

Sponsorship (Please tick) Self

Organization

If Organization: We wish to nominate this officer for the course indicated above and we undertake to pay his/her fees for the programme.

Name of Authorizing Officer: _______________________ Position: _______________________________

The Management University of Africa, Popo Road, Off Mombasa ROAD, Belle Vue, South C P.O Box 29677 -00100, NAIROBI, KENYA cpd@mua.ac.ke/www.mua.ac.ke Application Fees are payable by Bankers’ Cheque /draft, or a deposit to the University Bank Account Bank Account details: Management University of Africa, Barclays Bank of Kenya, South C, Red Cross Branch Account 2023842818 The Management University of Africa, Equity Bank, Westlands Branch Account 055-029 881 3541 Mpesa Paybill: Business No. 247247, Account No. 055 029 881 3541


TRAINING%20PROGRAMME%20APPLICATION