ENGA COLLEGE OF NURSING

Affiliated with Pacific Adventist University

Enga Campus

Application for Non–School Leavers

for Bachelor in General Nursing Training Program in 2023
Date Received Received by (Name) Application Status Approved by (Name)
Office Use Only

Complete this form in English, using a blue and black biro.

PART 1: GENERAL INFORMATION
Enga College of Nursing is an affiliated institution with Pacific Adventist University since Attach your
2017. The College accepts students from all parts of the country and is dedicated to train ID PHOTO
student nurses to be competent, committed and caring Christian nurses. The College is a HERE
Government institution which fosters Seventh Day Adventist principles. Therefore, student
activities are based on a Christian way of life with spiritual enrichment. Students are
expected to be willing to build up a Christian personality and community.
PART 1: PERSONAL DETAILS
Surname: Middle Name:
Given Name:
Title: (tick appropriate box) Ms  Miss  Mrs  Mr 
Marital Status Married / Single / Divorce / Separated / Widow
(circle appropriate name)
Gender: Age: Date of Birth: …../……/…..
Residential Address; Village: City/Town:
District: Country:
Nationality: Church Denomination:
Postal Address

Telephone/Fax: Mobile:
Email Address:
Current place of Residency:

PART 2: A) MARRIED APPLICANT INFORMATION

Name of Spouse: Qualification :
No of Children: Age of Last child:
Place of Residency: District: _______________Province: _____________
Telephone number: Email Address:
Mobile number:
Emergency Contact Number: Relationship to applicant (e.g. Husband, wife)
What is the best way we can contact you? Email:  Mobile number: 
Note: All married applicants are required to attach a consent letter from their spouse or partners to release them
for study.

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2023 APPLICATION – Enga College of Nursing Affiliated with Pacific Adventist University
PART 2: B) SINGLE APPLICANT INFORMATION
Name of Father/Guardian Qualification :
Name of Mother/Guardian: Qualification:
Place of Residency: District:________________Province: ____________
Telephone number: Email Address:
Mobile number:
Emergency Contact Number: Relationship to applicant (e.g. Father, Mother)

What is the best way we can contact you? Email:  Mobile number: 

PART 3: EDUCATIONAL BACKGROUND INFORMATION

Level of Education Year Completed Institution Award Obtained

Grade Ten
Grade Twelve
College/University

Have you been suspended or terminated from any Tertiary institution or University? Yes  No 
State the institution and specify your reason for suspension or termination:
……………………………………………………………………………………………………………………………………………………………………………………
Matriculation Grading done through Matriculation centres are required for justification
Name of designated Matriculation centre:
Subject Grading Subject Grading
Language Literature 1: Biology
Language Literature 2: Chemistry
Numeracy I Physic
Numeracy II Applied Science

PART 4: ACCOMMODATION STATEMENT

Note: It is our priority to accommodate students; however, we provide accommodation only to Full Time students
Please tick appropriate box below to indicate your preferred mode of accommodation;

Day student:  Boarding Student: 

PART 5 (a): FINANCIAL INFORMATION

1. How will you fund your COURSE?
a. SELF or PRIVATE (This means you or your parents /guardians will be paying the full course fee. 
b. Employer/Corporate Sponsor fully funded: 

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2023 APPLICATION – Enga College of Nursing Affiliated with Pacific Adventist University
PART 5 (b): EMPLOYER /CORPORATE SUPPORT
This section must be signed and stamped by an authorized person of the organisation.
Are you willing to support your employee financially and sponsor him/her for Bachelor in nursing training? 
Place your details below
Name of Organisation: Employers email address:
Name: Work Phone number:
Position: Home Phone number:
Address: Email address:
Signature of the authorized person:

PART 6: MEDICAL INFORMATION (DISABILITY OR SPECIAL NEEDS)

a) Please indicate if you have a disability (may include; partial deafness, eye sight, speaking problem), or any
chronic illness, or any allergies. (give a tick)
Yes:  No: 
b) If yes, then provide details or give more information:

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PART 7: PURPOSE OF CHOOSING ENGA COLLEGE OF NURSING

a) Write your REASON for choosing to come to Enga College of Nursing, Sopas.
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b) Write a short ESSAY about WHY YOU WANT TO BECOME A NURSE.

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2023 APPLICATION – Enga College of Nursing Affiliated with Pacific Adventist University
PART 8: REFEREES INFORMATION
Write down two (2) referees and their current phone numbers.
Referee 1 (Counsellor /Headmaster from previous
Referee 2 Minister/Pastor (current)
school (optional - either one of them)
Name: Name
Address: Address:

Work /Home Phone Work/Home Phone

Number Number
Email Address: Email Address:

PART 9: DECLARATION SECTION

I certify that this application is a true and complete disclosure of the information requested. I have
arranged to have the documents sent directly to the Principal’s Office at the Enga College of Nursing.
I understand that if my mailing address and contact numbers should change it is my responsibility to
ensure the Office of the Principal or Admin Officer or Registrar has the up-to-date information.

I understand that I must submit the following documents by Thursday, 30th September, 2022 to the Enga
College of Nursing, Administration Office.
• Bachelor of General Nursing Program Application
• Self-Appraisal form (CHWs only or those who are working already)
• Two letters of reference (each referee must submit a letter of Reference)
• It is my responsibility as the applicant to ensure that all references are received at the Enga
College of Nursing Admin Office.
• I understand that all documentation must be received or postmarked by Friday30th Friday, 2022.

I declare that all information provided is true in all its particulars and I’ll be responsible for any false
information that may lead to my exclusion in the selection process.

Signature: ……………………………………………………………….

Name of applicant: ……………………………………………………………. Date: ......................................

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2023 APPLICATION – Enga College of Nursing Affiliated with Pacific Adventist University
 PART 10: IMPORTANT INFORMATION
Note: Only students who apply directly to Enga College of Nursing will be considered for selection.

1. The application form will only considered if a bank receipt of K100.00 non-refundable fee is attached to this
application.
Application Fee can be deposited into the Institution Account;
Account Name: Enga School of Nursing
Account number: 1013033079
Bank: Bank of South Pacific
Branch: Wabag
Attach the copy of the deposit butt with the application. Do not send cash with this application form

2. CLOSING Date for Application is on Thursday, 30th of September, 2022. Any late applications will not be
accepted.
3. Successful applicants will be notified in due course.
4. Ensure that all required documents are attached with the application to avoid any penalties.

PART 11: IMPORTANT INFORMATION

Checklist - Have I fill in all the information? Please put a tick to make sure you have completed the form and attached
appropriate requirements.

 Have you attached your ID Photo?

 Have you attached your Deposit butt?
 Have you completed Part 1, 2?
 Have you completed PART 3, 4, 5, 6?
 Have you completed PART 7, 8, 9, 10?
 Have you attached the following documents?
 A photocopy of grade twelve
 A photocopy of grade ten certificate
 Photocopies of your current TRANSCRIPT (matriculation results if you are upgrading)
 Two (2) character references, one from your Church Minister, Counsellor or Principal from previous
School
 Spouse consent letter for married applicants.

Note: a) Incomplete applications will be disqualified.

b) Original documents will be sighted upon registration

PART 12: MAILING INFORMATION

Submit your completed Application to the Postal Address or email address below:
The Admission Officer
Enga College of Nursing
P.O. Box 421
WABAG
Enga Province Work Phone number: 79352144
Website: Email Address: engacon742@gmail.com

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2023 APPLICATION – Enga College of Nursing Affiliated with Pacific Adventist University