FORM1 - Kolandoto College of Health and Allied sciences

KCHS Mwanza – Student Joining Instructions Form 2026/2027

Kolandoto College of Health and Allied Sciences

Mwanza Campus · P.O. Box 2148, Kisesa, Mwanza · www.kchsm.ac.tz

Student’s Joining Instruction Form — Academic Year 2026/2027

Section 1 Applicant Details — Please fill in using BLOCK letters

First Name

Middle Name

Surname

Date of Birth

Nationality

Gender

Male Female

Marital Status

Single Married

No. of Children

Do you consider yourself to have a disability?

Yes No

Do you have any criminal conviction record?

Yes No

Applicant Address

Applicant Current Home Address

Applicant Permanent Home Address

City

Country

Post Code

Telephone

Email — Please write your e-mail address clearly

Parent / Guardian / Next of Kin

Parent Name

Telephone

Region

Nationality

Guardian / Relative Name

Telephone

Region

Nationality

Section 2 Course Details

Pre-Service Programmes

Ordinary Diploma in Clinical Medicine Ordinary Diploma in Pharmaceutical Science

In-Service / Upgrading Programmes

Ordinary Diploma in Clinical Medicine Ordinary Diploma in Pharmaceutical Science

Intake for which you are joining for

Course

Section 3 Finances — Mode of Payments

Tuition fees and other contributions are to be paid through the account number 0150605342100.
Account Name: KOLANDOTO COLLEGE OF HEALTH SCIENCES, MWANZA CAMPUS (CRDB Bank).
Please contact 0615 801748 / 0752197579 for further details.

Direct cost payments should be made to: Account Number: 0150552167400, Account Name: AICT KCHS DEVELOPMENT (CRDB Bank).

Terms of Payment:

Fees once paid are non-refundable if a student withdraws or leaves the college without permission from the Principal, is disqualified in an examination, or is dismissed for indiscipline.
However, 50% of the fees may be refunded if a student officially notifies the Principal of their intention to withdraw within the first four weeks from the beginning of the academic year.
Payments made by cheque, international money order (IMO), etc., are accepted only after bank clearance.
Fees can be paid either in full or in four installments, as outlined in the payment schedule.
The original bank pay-in slip must be submitted to the college accountant or cashier for official receipt and acknowledgment.

Note: Parents/guardians are strongly advised to make payments through the CRDB control number and ensure that students are given the bank pay-in slip for confirmation.

Section 4 Accommodation

All residents are required to sign an accommodation agreement before being allocated a room. For personal use you are required to bring: 1 mattress (size 3.5" x 6"), 1 bucket, mosquito net, pillow, bedsheet, and other hostel necessities.

Section 5 College Uniforms

College uniforms are available at the rate of TZS 120,000/=. This covers two pairs of Uniform and One Clinical Coat. Payment for college uniforms is made through CRDB Account No. 0150552167400, Account Name: AICT KCHS DEVELOPMENT.

Requirements for Each Programme

Clinical Medicine Course

1 Box of surgical glove, and 2 Reams of A4 Double A per annum.
1 Manual sphygmomanometer, 1 Patella hammer, 1 Stethoscope, 1 Tape measure, 1 Mercury Thermometer, 1 Pen Torch, 1 Tuning fork, 1 Pulse oximeter, 1 Fetoscope.

Pharmaceutical Science Course

1 Box of glove (Disposable), 2 Reams of A4 Double A per annum.
Scientific calculator, 1 Tanzania Pharmaceutical Handbook (TPH) 2nd Edition (available upon request at the college for Tsh. 60,000).

NB:

The requirement consists of one ream for Semester I and one ream and one pair of gloves for Semester II.
To enhance the learning process, students are encouraged to come with their own laptop computers or smartphones.

Section 6 Medical Status / Reports — Medical Examination Form

Medical Examination Form

(This section must be completed and signed at a recognized Government Hospital.)

Part I: Personal Particulars (To be filled by the candidate)

1. Full Name

2. Age

3. Sex

4. Course of Study

5. College Name

6. Marital Status

Part II: Medical History (Tick Yes/No)

Yes No

Part III: Physical Examination

1. Height (cm)

2. Weight (kg)

3. Skin

4. Eyes

5. Ears (state if any discharge)

6. Nose

7. Mouth and Throat

8. Any Abnormality

9. Cardiovascular System

a. Blood Pressure

Systolic: Diastolic:

b. Heart — Any Murmur?

c. Arteries and Veins

10. Respiratory System — Lung Fields

11. Abdomen

Part IV: Laboratory Results

Test	Result
1. Urinalysis
2. Stool Examination
3. Urine Pregnancy Test (Females)
4. Full Blood Picture
5. Widal Test
6. VDRL

Part V: Official Use (To be completed at a Government Hospital)

I have examined Mr./Miss/Mrs.

And consider that he/she is:

☐ Fit to be admitted to the college for higher education ☐ Unfit to be admitted to the college for higher education

Name of Examiner

Title

Qualifications

Address

Date

Signature

Stamp

Official Hospital Stamp Here

(This section must be completed and signed at a recognized Government Hospital.)

Section 7 Documents Required / Reporting — You Should Bring with You

1. This Joining Form (mandatory) 4. Three passport-size photos of the student (Attach to the front of this application) 2. Academic Certificate (mandatory) — Original Form Four Certificate or Results Slip 5. Bank Slips (Mandatory) 3. Birth Certificate

PLEASE NOTE: STUDENTS ARE REQUIRED TO BRING THEIR ORIGINAL DOCUMENTS (CERTIFICATE) ON REGISTRATION DAY.

REPORTING DATE: You are required to report at the college on 1st October, 2026.
Furthermore, visit our website www.kchsm.ac.tz for regular updates.

Section 8 Terms and Conditions

1 I am responsible for familiarizing myself with and abiding by all College student policies as outlined in the admissions guidelines.

2 I agree to meet all assessment and examination requirements as stipulated by the College, the Ministry of Health, Community Development, Gender, Elderly and Children (MOHCDGEC), and the National Council for Technical Education (NACTE).

3 I agree to comply with the College’s attendance policy and ensure that my class attendance is at least 90% throughout the duration of the course. I understand that failure to maintain this minimum level of attendance may result in disciplinary action, exclusion from further studies, and formal notification to my parents/guardian or sponsor in writing.

4 Fees once paid are non-refundable.

5 By agreeing to this declaration, I undertake to pay all fees as they become due, including any late fees or applicable collection surcharges.

6 I agree to fulfill my financial obligations to the College in full and by the due date provided in my payment plan. I understand that I will not be permitted to enroll, sit for examinations, or graduate if I fail to meet these obligations.

7 I hereby confirm that the information I have provided to the College is true and accurate, and that no material information relevant to this application has been withheld. I understand that the College reserves the right to take appropriate action if any part of the information provided is later found to be false.

8 I understand and agree that failure to pay fees on time may result in my elimination from the course.

Student’s Declaration for Admission Procedures:

I, hereby declare that:

1. The information provided in application form and supporting documents is true and correct to the best of my knowledge.

2. I understand that any false information or suppression of facts may lead to the rejection of my admission or cancellation thereof.

3. I agree to abide by the rules and regulations of the institution and accept the decision of the admission committee.

4. I undertake to pay the prescribed fees and fulfill all academic requirements for admission.

Name

Signature

Date

Section 9 College Registration Number

For Official Use Only — To be assigned by the College

Kolandoto College of Health and Allied Sciences — Mwanza Campus

Tuition Fee and Other Contributions for Academic Year 2026/2027

Department of Pharmaceutical Sciences

NO	Detail	Semester 1 (TZS)
1	Tuition fee	1,000,000.00
Other Contributions
2	Internal examinations	200,000.00
3	Accommodation	150,000.00
4	Library services	25,000.00
5	College development	50,000.00
6	Tehama / Internet	25,000.00
Total Payment per Semester		1,450,000.00

NB:

1. ADA NA MICHANGO MINGINE YOTE (DIRECT COST) YA CHUO INALIPWA KUPITIA BENKI YA CRDB KWA CONTROL NAMBA ZINAZOPATIKANA KUTOKA OFISI YA UHASIBU. KUPATA CONTROL NAMBA YAKO NA MSAADA WOWOTE WA MALIPO TAFADHALI PIGA SIMU ZIFUATAZO; 0621521748 SIKU ZA KAZI KUANZIA SAA 2:00 ASUBUHI MPAKA SAA 10:00 JIONI.

2. MWANAFUNZI AJE NA RIMU PEPA 2 (DOUBLE A), 1 CLEAN GLOVES.

3. MALIPO YEYOTE YA TASLIMU HAYARUHUSIWI CHUONI, MWANAFUNZI AKISHALIPIA AHAKIKISHE ANAWASILISHA SLIP YA MALIPO YENYE MUHURI WA BENKI/ WAKALA UHASIBU.

PRINCIPAL

Kolandoto College of Health and Allied Sciences — Mwanza Campus

Tuition Fee and Other Contributions for Academic Year 2026/2027

Department of Clinical Medicine

NO	Detail	Semester 1 (TZS)
1	Tuition fee	1,000,000.00
Other Contributions
2	Internal examinations	350,000.00
3	Accommodation	150,000.00
4	Library services	25,000.00
5	College development	50,000.00
6	Tehama / Internet	25,000.00
Total Payment per Semester		1,600,000.00

NB:

2. MWANAFUNZI AJE NA RIMU PEPA 2 (DOUBLE A), 1 CLEAN GLOVES.

3. MALIPO YEYOTE YA TASLIMU HAYARUHUSIWI CHUONI, MWANAFUNZI AKISHALIPIA AHAKIKISHE ANAWASILISHA SLIP YA MALIPO YENYE MUHURI WA BENKI/ WAKALA UHASIBU.

PRINCIPAL

Kolandoto College of Health and Allied Sciences — Mwanza Campus
P.O. Box 2148, Kisesa, Mwanza | www.kchsm.ac.tz | info@kchsm.ac.tz | 0752 197 579