THE NATIONAL BOARD FOR MATERIALS MANAGEMENT by as8jkdkL

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									               THE NATIONAL BOARD FOR MATERIALS MANAGEMENT
                          (Incorporated by Act No. 9 of 1981)                                                Affix
           APPLICATION FOR REGISTRATION AS AUTHORIZED SUPPLIES OFFICER/                                    Photo Here
          AUTHORIZED STOCK VERIFIER, APPROVED SUPPLIES OFFICER/APPROVED
                                 STOCK VERIFIER

I hereby apply for registration as Authorized Supplies Officer/Stock Verifier/Approved Supplies Officer/Stock
Verifier.

SECTION A:        PERSORNAL PARTICULARS

1.   Name: ………………………                        ……………………..                …………………………………….
                  First Name                   Other Initials                        Surname

2.   Gender:     Please tick (√) Male □ Female □

3.   Place and Date of Birth: ………………………………………… Nationality: ………………………………
4.   Address:………………………………..Tel/Mobile No.………………… Email………………………………
5.   State particulars of previous registration: ……………………… … ………………………. ……………..
                                                Name of the Board Reg. No. Date

6.      SECTION B:        EDUCATION & PROFESSIONAL QUALIFICATIONS

                                                                  Date
S/N                 School/Institution                     From           To                   Awards




7.      SECTION C:        EMPLOYMENT RECORDS

S/N                     Employer                                  Date                       Designation
                                                           From            To




                                                       1
8. Describe your duties and responsibilities to your present employer..
……………………………………………………………………………………………………………………….
……………..…………………………………………………………………………………………………………

SECTION D:             REFERENCE & DECLARATION

9.   Give names and addresses of two referees who are Senior Officers. One of whom must be authorized or
     Approved Supplies Officer or Stock Verifier other than your current supervisor.

                 NAME                        ADDRESS                         E-mail                 RELATIONSHIP                     REG.
                                                                                                                                     NO.




10. Name, Designation and Address of the Officer to whom you report:
    ……………………………………………………………………………………………………………………
    ……………………………………………………………………………………………………………………

11. I, ………………………………………………………………………………………………… the applicant
    hereby declare that the particulars given above are correct and I undertake to abide to the rules regulations
    made by the Board for professional conduct and ethics for Supplies Officer and Stock Verifiers.

     Date: …………………………………                                                                    Signature:…………………………………

SECTION E: GUIDANCE NOTICE
           1.    For completion for professional registration the following notes should be read in conjunction with
                 the relevant sections of Professional Registration Application Form.
           2.    Application fee of Tshs. ……………………… must be submitted with application forms. All fees
                 paid are non-refundable.
           3.    Recently taken passport size photographs (2) with your name written on the back of each one must
                 be submitted with the form.
           4.    Photocopies of certificates certified by the issuing Authority must accompany this Application.
                 Alternatively, they may be delivered personally to the Board.
           5.    Original certificates should never be forwarded or sent by post
           6.    In complete forms and forms not supported with relevant documents and appropriate fee will not be
                 processed

SECTION F:             REGISTRATION ELIGIBILITY

Registration accepted/rejected for the following reasons:...........................................................................................
………………………………………………………………………………………………………………………...
Form and Documents checked by:……………………………………… Date:……………………………………...
Receipt No.:……………………………of Tshs……………………………Received by …………………………Date ………………………..
This form is not valid without Registrar’s stamp and signature


Approved:                                                                                    NBMM, P.O. Box 5993, Dar es salaam.
                                                                                              Tel: 022 2865860 Fax: 022 2862138
Registrar, National Board for Materials Management
Email: nbmm@africaonline.co.tz                                                               Website: http://www.nbmm.or.tz
                                   *Attach a separate sheet if the space is not enough
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