1. ZB BANK LOCAL CURRENCY ACCOUNT 4112-510262-200
2. ZB BANK NOSTRO ACCOUNT 4112-510262- 405

I have read and understood the contents of this application. I declare that to the best of my knowledge and belief, the above information is correct and that should the information be found incorrect and misleading, my application may be invalidated. I undertake to abide by the rules of the SCHOOL OF CHAPLAINCY. I hold myself responsible for the payment of tuition and ZCMA annual membership fees where applicable and other charges due and payable by me to the SCHOOL OF CHAPLAINCY as prescribed in the school’s Terms of Payment. I hereby waive all claims against the school of any damages or loss suffered while l am, or as a consequence of my being, a student of the school of chaplaincy and arising out of death, bodily injury, loss of health or illness suffered by me or any other person and loss or destruction of, or damage to any property belonging to me or any other person, howsoever such damage or loss is caused, including but not limited through the negligence of the school or any official, employee or representative of thereof. I or my estate hereby indemnifies the School of Chaplaincy against any claims by any person arising in any way as stated above in respect of my own negligent or wilful acts or omissions.

• Signature of Applicant_______________________________
• Date