Data Collection and Registration Form

Your Institution

Name of the Institution

Year of Establishment

Location of the Institution

UGAPRIVI Region
District
County/Subcounty
Plot No.
Description
P.O. Box / Town

Phone Other Phone

Email Address
Website

Principal Phone Other Phone

Type of the Institution

  1. Entry Requirements PLEUCEUACENon Formal
  2. Sex MixedGirlsBoys
  3. Boarding Facilities DayBoardingDay and Boarding
  4. Location UrbanPeri-UrbanRuralRural & Very Remote

Registration

Ministry of Education and Sports Licence No. Date
UBTEB Business Exams Centre No. Date
UBTEB Technical Junior Exams Centre No. Date
UBTEB Technical Certificate Exams Centre No. Date
UBTEB Technical Diploma Exams Centre No. Date
DIT Exams and Assessment Centre No. Date
NCHE Provisional Licence No. Date
NCHE Certificate of Reg. & Classification No. Date
UGAPRIVI Registration No. Date
Others
Affiliations to other Institutions
Does the Institution have other campuses? NoYes

What's their location?

Ownership

Type of Ownership
Name of Director

Phone Other Phone

Email
Website

Board of Govenors/Governing Council

No. Name Sex Appointment Date Expiry Date Representation Position
1
2
3
4
5
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9
10
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15

Academic Staff

No. Post/Title Name Sex Date of birth Registration No. / UTS No. Employment Status Date of Appointment Teaching Qualification Qualification Courses/Programmes
1
2
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35
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37
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40
11
42
43
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45
46
47
48
49
50

Administrative Staff

No Name Sex Position Qualification
1
2
3
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5
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Programmes offered and Enrolment

No. Programme/Course Level Year one Year two
Male Female Male Female
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
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20
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25
UGAPRIVI is emphasising training with production, which of the above programmes have been embedded into production and what are you producing?

Basic Physical Training Facilities & Infrastructure

Buildings

Permanent (Number) Temporary (Number) Size Owned/Rented Total
Classrooms
Workshops
Staff Rooms
Library
Store
Staff Houses
Offices
Examination Hall

Land

Description Surveyed/Unsurveyed Address Hectares Rented/Owned

Machinery and Equipment

Type Brand/Model How many?

Water and Sanitation

What's your source of water? National WaterBoreholeCommunity WellRain WaterStream/RiverLakeOthers


How many stances of pit latrines do you have?

Male Female



How many bathrooms/shelters do you have?

Male Female

Means of Communication and Power Source

Does your Institution have a vehicle? NoYes

How many?

Source of power UMEMESolarGeneratorOtherNo Power

External Support

Does your Institution receive any donor support? NoYes

Please specify

Monitoring and Inspection

Have you been inspected by any government organ? NoYes

Please specify

Did you receive the monitoring/inspection report? NoYes

Please attach the report (max. file size 1 MB)

Parents/Community Involvment

How often do you hold open days (in a year)?
How often do you hold parents days (in a year)?
How often do you hold sports days (in a year)?
How often do you hold exhibition days (in a year)?
Others
Do you conduct tracer studies? NoYes

What's the impact in Percent?
Formally Employed Self Employed Unemployed

How many students do you send for Industrial Training (per year)?

Medical Facilities

Do you have a clinic at your institute? NoYes

How far are the next medical facilities from your school (in km)?


Membership

Membership is open to all Institutions, groups and individuals provided they subscribe to the objectives of UGAPRIVI and are willing to pay for registration and renewable annual subscriptions fee.
Please choose the type of membership:



Additional suggestions and ideas

Attachments

For our website we request some photos. Please attach the files.
Logo of your Institution (max. file size 1MB)

Pictures of your Institution (max. file size 1MB)

Confirmation

Name
Title

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