Application form for final-year students requesting ...

1 83 Application form for final- year students requesting registration for 12 modulesDSAR06 Student numberQualificationQualification code and specialisation (if applicable)Indicate the number of modules that you have already passedIndicate the average percentage of all previous modules registered (average must be 55% for an extra 2 modules to be considered)Additional 2 modules for which you wish to registerModule codeSemester periodLanguage (E or A)FOR OFFICE USE ONLY1 The student academic record is attached (Y/N)?2 The Application complies with the conditions prescribed by the Senate decision (Y/N)?

2 Approved Not approvedUnisa Deputy Registrar (or delegated authority)YesNoYesNo 1 2 Y Y Y Y M M D DStudent signatureThis form can be faxed to 012 429 4150 or posted to the university at PO Box 392, Unisa, 0003 Please note: Unisa does not accept any forms submitted via