FILL IN AN ONLINE FORM BELOW OR DOWNLOAD AN OFFLINE FORM Click Here To Download Offline Form Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.ELSIMATE INSTITUTE EXEMPTION FORMEXEMPTION APPLICATION FORM Code: Version No: 01 Effective Date: 01.04.2022Name *FirstLastID Number/Passport Number * (Work) ELSIMATE No Address *Address Line 1Address Line 2CityState / Province / RegionPostal Code--- Select country ---AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia (Plurinational State of)Bonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo (Democratic Republic of the)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Kingdom of)EthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIran (Islamic Republic of)IraqIreland (Republic of)Isle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea (Democratic People's Republic of)Korea (Republic of)KosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia (Federated States of)Moldova (Republic of)MonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth Macedonia (Republic of)Northern Mariana IslandsNorwayOmanPakistanPalauPalestine (State of)PanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyrian Arab RepublicTaiwan, Republic of ChinaTajikistanTanzania (United Republic of)ThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUgandaUkraineUnited Arab EmiratesUnited Kingdom of Great Britain and Northern IrelandUnited States Minor Outlying IslandsUnited States of AmericaUruguayUzbekistanVanuatuVatican City StateVenezuela (Bolivarian Republic of)VietnamVirgin Islands (British)Virgin Islands (U.S.)Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsCountryTel No (Work)Tel No (Home) CellEmail *Name Of Qualification Studied *Name Of Programme/Course Applied *Additional Supporting DocumentationApplicants with qualifications from outside of Botswana will be required to submit additional supporting documentation, course curriculum, individual subject syllabus and the course rating.ElsiMate SubjectSubject Considered Compatible with Elsi-Mate SubjectName of Institution/College AttendedYear ObtainedMarks/GradeNotesUpload Additional Supporting Documentation Click or drag a file to this area to upload. Maximum file should be 2MB Please note: 1. A certified copy of the academic record, with symbols, must be attached to this application form 2. An exemption fee of P150.00 for our former learners must accompany this application form. Learners from other institutions pay a P250.00 exemption fee. 3. A direct deposit must be made to: 1. FNBB, First Place Branch: 62064341507 Branch Code 281467 OR 2. ABSA, Broadhurst Branch: 1084650 Branch Code 04 OR 3. Orange Money: Kgaimene Mosweu: 77927224 OR 4. Myzaka: Kgaimene Mosweu: 71261547 [REFERENCE - write your FULL NAMES] Proof of payments should always be sent to accounts on 77927224 OR Customer Service: 71809178 4. Applicants who are granted exemption shall become liable to the ElsiMate Institute for the exemption fee 5. Only modules completed during the last 5 years will be considered for exemptions. 6. A pass of 50% or above is applicable to be considered for exemption. EXEMPTION PROCEDURE Modules completed during the 5 years will be considered for exemptions. Procedure 1. Fill in the exemption Application Form and pay the exemption application fee. 2. Post or hand in an original or certified copy of the academic record, with symbols or percentages, to ElsiMate together with the exemption Application Form and proof of payment. If the marks obtained for a subject do not appear on the academic record, the student will not qualify for an exemption. The year the module was written must also appear in the academic record. 3. A copy of the syllabus of the relevant subjects applicable to the period when the subject/s were completed should be attached to the qualification. Further notices 1. The exemption fee (per module) is determined annually. Please see the fee structure on the ElsiMate prospectus. 2. All registered students will automatically have their account debited for exemptions granted which need to be paid immediately. 3. Non-registered students must submit a copy of the exemption letter upon registering, in order to complete the exemption process. 4. Exemption fees are non-refundable 5. If a student has attempted a subject with ElsiMate in the past, and failed this subject, they may not apply for an exemption if they pass the said subject at another institution. 6. If a module has been passed at a public university, and accepted by the ElsiMate, the pass rate accepted must be 50% or higher. Signature Click or drag a file to this area to upload. Maximum file should be 2MBDate Submit