ESPAM–FORMATION UNIVERSITY
Ecole Supérieure Panafricaine de Management Applique
Application for Admission for the degree of Doctor of Philosophy (Ph.D.)
(To be forwarded through the Head, Place of Research)
1. Faculty: ………………………………… 2. Subject: ……………………………………….
3. Research Topic: ……………………………………………………………………………...
………………………………………………………………………………….…………………
...........................................................................................................................………….
To,
The Registrar
ESPAM FORMATION University
06 BP: 1738 Cotonou Republic of Benin
Dear Sir/ Madame
I hereby apply for admission to the Ph.D. Degree. I state that I have not been admitted as a
student for this or any other Degree in this or any other University. The required details about
myself are as follows:
1.Name in full (in Capital Letters) : ……………………………………………………………… ……...
(Beginning with Surname) (Surname) (Name) (Father/Husband) (Mother’s Name)
2.Date of Birth : ………………………………………………………………………………………….
3.Gender: Male/Female (Strike out whichever is not applicable)
4.Nationality: …………………………………………………………………
5.Permanent Address: …………………………………………………………………………………...
……………………………………………………………………………………………………… ……
6.Present (Local) Address: ………………………………………………………………………………
…………………………………………………………………………………..
7. Present Occupation/Employment ………………………………………………………… …………..
(Give Name and Address of the Employer) ……………………………………………………………...
| Degree | University | Year of Graduation | Subject Offered | Class Grade | Percentage Grade Point |
| Bachelor’s Degree | |||||
| Master’s Degree | |||||
| M. Phil. Degree | |||||
| Any other Degree/Diploma |
9. Particulars of Publications:
| Title of Book | Name of Journal/Publisher | Place and Year of Publication |
| 1 | ||
| 2 | ||
| 3 |
10. Details of Teaching Experience:
| Name of Institution | Subject(s) Taught | Year(s) |
11. Details of professional experience, if any (Attach necessary Certificates)
(i) Nature of Professional Experience: …………………………………………..……...……………….
(ii) The Institute where Professional experience was gained: …………………………...……………...
(iii) Period of Professional experience: ..……………………………….…………...…………………..
12. (i) Title of M. Phil. Dissertation, if applicable
……….…………………………..………...…………………………………………………………….
………………………………….………………………………………………………………………...
(ii) Is the Proposed topic of Doctoral Research Related to or an Expansion of the M. Phil
dissertation? Yes / No
13. Name of the Research Guide: …..…………………………………………….………… …………...
(under whom I propose to work for my Ph.D.)
14. Name and address of the approved place of research (where I desire to do Doctoral Research)
:……………………………………...……………………………………………………………………
All the particulars given above are true to the best of my knowledge .I have read the Rules for the
Degree of Doctor of Philosophy (Ph.D.) and I undertake to abide by them. I also undertake
to regularly report at the Place of Research unless otherwise permitted by the Head, Place of
Research on the recommendation of the Research Guide.
Eight copies of the research outline and a duplicate copy of the registration and acceptance fee receipts
are enclosed.
Thank you
Sincerely yours,
Applicant Signature: …………………………….
Date: ……..……………………...