NATION PUBLICATIONS LIMITED

SELF-MANAGED LEARNING

REGISTRATION FORM

Part 1: To be completed by employee

Name:………………………………………………………..……………………… Grade:…………………………

Department:……………………………………………………………………

Current Highest Educational/professional Qualification:……………………………………………………………...………………………………………………….

CURRENT APPLICATION

I apply to study

Name of Program…………………………………………………………………………………………………………….

Examining Body:………………………………………………………………………………………………………………

Qualification To Be Obtained:

..............................................................................................................................................

..............................................................................................................................................

State motivation for pursuing learning programme. Tick the three most important motivations

1. Improve current performance in current job [ ]

2. Improve or acquire new skills [ ]

3. Extend relevant knowledge [ ]

4. Develop specified area of competency [ ]

5. Moving across or upward within NPL [ ]

6. Preparing for changes in the current role [ ]

Subjects/modules (List them down):

Subject Examination Date…………………………………………………………….. ……………………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………………….. ………………………………………………………………………………………………………………………… ………………………………………………………….

Mode of attendance: [ ] Day release [ ] Weekend [ ] Home study

Expected Date of Completion:………………………………………………………………………………….

Signature:……………………………………………………………………. Date:………………………………….

Part 2: To Be Completed by Head of Department in consultation with Immediate Supervisor

I recommend/do not recommend.State reasons

a) Recommend: …………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………

b) Do not recommend:…………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………

Name:……………………………………..……….. Signature:…………………………. Date:…………….…….

Part 3: To be completed by Learning & Development Manager

I recommend/do not recommend

State reasons:

a) Recommend: …………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………

b) Do not recommend:…………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………

Name:……………………………………………… Signature:……………………….. Date:……………………….

Part 4: To be completed by Chief Executive Officer

I approve/do not approve

State reasons:

a) Approved: …………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………

b) Not approved:…………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………

Name: ……………………………………………………… Signature……………………. Date:……………………