SRC-Form

1.4

The Nelson
Mandela
African Institute of Science and
Technology
Student Research Direct Cost Application Form (SRDCF)
PART I: APPLICANT
[STUDENT]

DATE: 23/04/2015

Name: ERICK A. MASSAWE

.P127/T.13

Registration No.:

School/Department: COCSE
Work plan Activity No. ONE

[Endorsed

Workplan to be attached] Brief Description of Activity (Number of

field days/Transport/Labour/etc)
Transport

and

subsistence

allowances-

Field

Visit

for

requirement gathering at Tarangire, Ngorongoro and Manyara

national parks. Also data collection in Dar-es salaam (Ministry
of natural resources and tourism and TCRA)
Amount TShs: 1,600,000

[Show breakdown on a

separate sheet] Expected date of completion (Activity(ies): 10 July

2015
Retirement date: 10 October 2015 Applicants signature:
.....
PART II: SCHOOL/DEPARTMENT
The research Proposal and its work plan was discussed and approved:
Name: KISANGIRI MICHAEL
[Supervisor]

Signature:
Date: 23/04/2015

Name: ................................................................

[Dean/Head of Department]
Date:
.

Signature:

PART III: BURSARS OFFICE

The applicant has/hasnt an outstanding imprest balance of Tshs.
...........................................

NB: NO IMPREST SHALL BE ISSUED WHERE THERE IS AN OUTSTANDING BALANCE

The application is therefore recommenced/not recommenced

Name : Signature:
......................................
Designation .
................................................
PART IV:

Date:

AUTHORIZING OFFICER

The research imprest is approved/not approved:

Reasons: .......................................................................................................
....................
Name : Signature:
......................................
[DVC-ARI]
Date: