Apply for Elective Studies

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MUHAS Elective Studies Application Form

Personal Information

Surname

First Name

Middle Name

Sex

Female Male

Date of Birth

Place of Birth (Country)

Religion

Marital Status

Citizenship

Country of Residence

Address (if application is successful)

Education & Background

Names and dates of Secondary School/College attended

Employment or further courses of study (if left school)

Referee (Full name and contact information)

Elective Study Details

Level of study you are applying

Undergraduate Postgraduate

Study Department for which you are applying

State Objective of your elective study visit

Effective date of your elective period

Duration of your elective study (in weeks)

STATEMENT BY APPLICANT

I have acquainted myself with the entrance qualifications for admission to the Muhimbili University of Health and Allied Sciences (MUHAS) and with the course available, and certify that to the best of my knowledge the information given above is correct.

Signature (Full Name)

Upload the Signed and Stamped Introduction statement (PDF) from your Dean or Principal

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Also upload Transcript

Click or drag to upload transcript (PDF format preferred)

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Please ensure all required fields are filled correctly before submission. You will receive a confirmation email once your application is received.

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