CHANGE OF MODE OF STUDY APPEAL
FORM
University of Zambia
FORM FOR LODGING AN APPEAL FOR CHANGE OF MODE OF STUDY
SECTION 1. PERSONAL DETAILS
Surname: Enter text Other name(s): Enter text
Computer number: Enter text
School: Enter text
Programme of study: Enter text
Current Mode of study: Enter text
Contact details for correspondence relating to your appeal (communication will be by email):
Email address: Enter text
Postal address: Enter text
Enter text
Enter text
Telephone: Enter text
Note carefully that a student who wishes to change the mode of study must have cleared all
courses in the programme he or she is following before the change.
1
SECTION 3. TYPE OF CHANGE
Click the relevant box:
From full time to distance education
From full time to part time
From distance education to full time
From part-time to distance education
From parallel studies to distance education
From parallel studies to full time study*
*Please note that, under normal circumstances, students enrolled in parallel programmes are not
permitted to change to regular full time studies. This change is allowable only in exceptional cases
which are supported by evidence of hardship and the need for a obtaining a government-sponsored
loan.
SECTION 4. DETAILS OF THE APPLICATION
Use the relevant box(es) below to explain in full the grounds on which your application is based
and also the other details as follows:
Detailed description of your claim
Enter text
Relevant third party evidence to support your application
List the documents you are submitting with this form. Documentary evidence should be scanned and
submitted electronically wherever possible. Please note that:
(a) Evidence must be supplied in English. If the original is in another language, you must obtain
and submit a certified copy in English.
(b) The evidence should be dated.
Enter text
`
SECTION 5. CHECKLIST
Click box to select:
I have read and understood the ‘Appeals for Change of Mode of Study - Guidelines for
Students’
I have provided on/with this form all the information that I wish to be consider in relation to
my appeal
2
SECTION 6. DECLARATION
By submitting this form: I declare that the above information is accurate and true; I confirm that
the details of this application are complete and can be passed on to the relevant University staff
considering this case; I confirm that I have included relevant third party documentary evidence
to support my case (where applicable).
SECTION 7. SUBMISSION OF THE APPLICATION FORM
Submit the completed appeal form and supporting evidence to the email address given below to be
received before the expiry of the appeal submission deadline. Appeals should be submitted
electronically wherever possible.
Date of submission: Enter text
Submit the appeal by email to: dean.xxx@unza.zm (please obtain correct email address)
SECTION 8: RESOLUTION OF THE APPEAL
A. DEAN MAKES CONSULTATIONS IN THE SCHOOL AND THE SCHOOL TO WHICH
THE STUDENT WISHES TO TRANSFER
Dean’s comments:
Enter text
B. ADMISSIONS AND QUOTAS COMMITTEE CONSIDERATIONS
Committee’s comments:
Enter text
Change of mode of study approved
Change of mode of study not approved
C. ACADEMIC OFFICE NOTIFICATION
Date of Receipt of Committee’s Comment: Enter text
