Vut Application Form

							Vaal University of Technology

Co-operative Education

Application form for in-service training

Faculty: Management Sciences

Name                     Type here            Surname                Type here
Student Number           Type here            Postal Address         Type here
Province                 Select One           ID Number              Type here
Telephone No             Type here            E-mail                 Type here
Gender                   Select One           Home Language          Type here
Drivers Licence          Type here            Course                 Select One
Present level of         Select One
Study
Academic History         Average 1st Year     Type here
                         Average 2nd Year     Type here
                         Average 3rd Year     Type here


Work Experience          Type here


References                Name                 Relationship           Contact No
1.                        Type here            Type here              Type here
2.                        Type here            Type here              Type here
3.                        Type here            Type here              Type here
4.                        Type here            Type here              Type here
5.                        Type here            Type here              Type here
It is essential that the personal particulars you place on this form is available, correct
and detailed so that we (or companies) can contact you at any time. The Vaal
University of Technology will authenticate the student’s information. We will
appreciate it if you can inform us once you find an experiential learning opportunity.

The student will be requested to submit a detailed CV, academic results and other
information directly to companies if considered for an interview.


I accept the terms and conditions as stipulated above        Please tick


NB: The responsibility to find an experiential learning opportunity lies with the
student, however, the Co-operative Education Department will assist students
in this process.