Application Form For License As A Veterinary Laboratory Technician (Page 2 of 2) in pdf

Application Form For License As A Veterinary Laboratory Technician Page 2

SECTION C: APPLICANT SATUTORY DECLARATION

I…………………………………………………………. do hereby declare on this …….

day of….. that I am the person who is applying for a license as a veterinary laboratory

technician and I am holding the above qualification and that the information I have given

is true and correct to the best of my knowledge and belief.

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

CERTIFICATION: (To be certified by advocate/magistrate/notary public)

I certify that I have compared the photograph in the application form shown to me this

………….. day of ……..…. by ……………………………………………….with his

application before me and that in my opinion it is a true and faithful likeness and I am

satisfied that the applicant before me is the person to whom the photograph and

application relates.

Name: ……………………………………………..

Qualification ……………………………….

Signature………………………………………….

Address: ……………………………………………………………………………………

…………………………………………………………………………………….

SECTION D: FOR OFFICIAL USE ONLY

Licensed-----------------------------------------------------------------------------------

Reasons (If not licensed).

………………………………………………………………………………………………

Chairman

Registrar

Veterinary Council of Tanzania

Date………………………

Application Form For License As A Veterinary Laboratory Technician Page 2