Embed Size (px)
Citation preview
Page 1 of 8 Fomu Na 6E(iii) (KUOMBA UONGOZI NDANI YA CHAMA -BAVICHA)
Fomu Na. 6E(iii)
FOMU YA KUOMBA NAFASI YA UONGOZI NDANI YA CHAMA
NGAZI YA WILAYA
BARAZA LA VIJANA CHADEMA - BAVICHA
(Gharama ya fomu hii ni Tsh 30,000)
JIMBO _______________________WILAYA______________________
MKOA________________________KANDA ______________________
(Imetolewa chini ya Ibara ya 6.3.1( b) ya katiba ya chama na Kanuni ya
(7.2.3) ya kanuni za chama. Katiba ya mwaka 2006 toleo la mwaka
2016)
A. MAELEKEZO YA UJAZAJI WA FOMU:
1. Fomu hii ijazwe kikamilifu kwa herufi kubwa kwa kutumia kalamu ya
wino mweusi/blue.
2. Kutokujaza sehemu yoyote itakuwa ni moja ya mapungufu ya fomu.
3. Fomu hii ijazwe na anayeomba kugombea.
4. Fomu hii irejeshwe na nakala (COPY) ya kadi ya uwanachama iliyolipiwa
mpaka muda ulioujaza kipengele cha (2.0) cha fomu hii.
5. Fomu hii irejeshwe ikiwa na picha ya anayeomba nafasi ya kugombea
yenye muonekano wa kitambaa cha blue kwa nyuma
6. Fomu hii irejeshwe ikiwa na nakala (COPY) ya cheti cha kuzaliwa/kadi ya
mpiga kura/kitambulisho cha Taifa/hati ya kusafiria/leseni ya udereva
PICHA
Page 2 of 8 Fomu Na 6E(iii) (KUOMBA UONGOZI NDANI YA CHAMA -BAVICHA)
1.0 MAELEZO BINAFSI
1.1 NAFASI UNAYOOMBA KUGOMBEA______________________
MAJINA:
LA KWANZA ___________________________________________
LA PILI ___________________________________________________
LA TATU ______________________________________________
1.2 JINSIA
MWANAUME
MWANAMKE
1.3 NAMBA YA SIMU _______________________________________
BARUA PEPE __________________________________________
1.4 TAREHE YA KUZALIWA ________________
1.5 UNAPOISHI
MKOA ________________________________________________
WILAYA ______________________________________________
JIMBO ________________________________________________
KATA ________________________________________________
MJI/MANISPAA/JIJI ______________________________________
KIJIJI/MTAA ___________________________________________
MSINGI/KITONGOJI ______________________________________
1.6 URAIA
WA KUZALIWA ______________
WA KUJIANDIKISHA _____________ NAMBA __________________
2.0 MAELEZO YA UANACHAMA WAKO
Tarehe ya kujiunga na Chama ____________________________
Namba ya kadi ya Uanachama ____________________________
Kadi imelipiwa mpaka Tarehe _____________________________
Tawi lako la Chama ____________________________________
Msingi wako _________________________________________
Page 3 of 8 Fomu Na 6E(iii) (KUOMBA UONGOZI NDANI YA CHAMA -BAVICHA)
(Kama nafasi ya fomu hii haitatosha kujibu kipengele 2.1, 2.2, 3.3,
3.4, 3.5 & 3.6 weka maelezo ya kipengele husika katika
kiambatanisho
2.1 Wadhifa ndani ya CHADEMA.
Eleza kwa kifupi nyadhifa na muda uliowahi kushika nyadhifa hizo.
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
2.2 Umewahi kusimamishwa/kufukuzwa Uanachama ______________
Kama ndiyo toa maelezo, Sababu uliyofukuziwa, Lini na wapi
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
3.0 MAELEZO KUHUSU UWEZO, UZOEFU NA ELIMU
Elimu ya mgombea.
Shule ya msingi____________________Kuanzia _____hadi____
Sekondari (O’level) _________________ Kuanzia_____hadi_____
Sekondari (A’level)__________________Kuanzia_____hadi_____
Chuko kikuu______________________ kuanzia_____hadi_____
Page 4 of 8 Fomu Na 6E(iii) (KUOMBA UONGOZI NDANI YA CHAMA -BAVICHA)
Eleza cheti cha juu ulichonacho
Chuo kikuu _________________________________________
Diploma __________________________________________
Kidato ____________________________________________
Mengineyo ________________________________________
3.1 Eleza kazi unayofanya/shughuli yako halali
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
3.2 Lugha unazomudu kuzungumza (Kata isiyohusika)
Kiswahili Ndiyo/Hapana
Kingereza Ndiyo/Hapana
Nyenginezo __________________________________________
3.3 Uzoefu wa kiuongozi (Eleza kwa ufupi)
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
Page 5 of 8 Fomu Na 6E(iii) (KUOMBA UONGOZI NDANI YA CHAMA -BAVICHA)
3.4 Kabla ya kujiunga na CHADEMA uliwahi kuwa mwanachama wa
vyama /chama kingine cha siasa? __________________________
Kama ndiyo toa maelezo
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
3.5 Nini Dira, Mwelekeo na Matarajio yako ukipata wadhifa
unaouwomba?
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
Page 6 of 8 Fomu Na 6E(iii) (KUOMBA UONGOZI NDANI YA CHAMA -BAVICHA)
3.6 Je umewahi kuhukumiwa kwa kosa la jinai? __________________
Kama ndiyo toa maelezo
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
4.0 UTHIBITISHO:
Ninathibitisha kuwa maelezo niliyotoa hapo juu yote ni sahihi
Jina _________________________________________________
Sahihi _______________________________________________
Tarehe _______________________________________________
Mahali _______________________________________________
5.0 WADHAMINI WA MGOMBEA
a) Jina kamili __________________________________________
Namba ya simu _______________________________________
Barua pepe __________________________________________
Nambari ya kadi ya chama _______________________________
Sahihi _____________
b) Jina kamili __________________________________________
Namba ya simu _______________________________________
Barua pepe __________________________________________
Nambari ya kadi ya chama _______________________________
Sahihi _____________
Page 7 of 8 Fomu Na 6E(iii) (KUOMBA UONGOZI NDANI YA CHAMA -BAVICHA)
c) Jina kamili __________________________________________
Namba ya simu _______________________________________
Barua pepe __________________________________________
Nambari ya kadi ya chama _______________________________
Sahihi ______________
d) Jina kamili __________________________________________
Namba ya simu _______________________________________
Barua pepe __________________________________________
Nambari ya kadi ya chama _______________________________
Sahihi ______________
e) Jina kamili __________________________________________
Namba ya simu _______________________________________
Barua pepe __________________________________________
Nambari ya kadi ya chama _______________________________
Sahihi ______________
f) Jina kamili __________________________________________
Namba ya simu _______________________________________
Barua pepe __________________________________________
Nambari ya kadi ya chama _______________________________
Sahihi ______________
g) Jina kamili __________________________________________
Namba ya simu _______________________________________
Barua pepe __________________________________________
Nambari ya kadi ya chama _______________________________
Sahihi ______________
Page 8 of 8 Fomu Na 6E(iii) (KUOMBA UONGOZI NDANI YA CHAMA -BAVICHA)
h) Jina kamili __________________________________________
Namba ya simu _______________________________________
Barua pepe __________________________________________
Nambari ya kadi ya chama _______________________________
Sahihi ______________
i) Jina kamili __________________________________________
Namba ya simu _______________________________________
Barua pepe __________________________________________
Nambari ya kadi ya chama _______________________________
**************************************************************
6.0 KWA MATUMIZI YA OFISI
Fomu ya maombi imepokelewa Tarehe ____________Saa _________
Aliyeipokea ____________________________________________
Nafasi/Cheo ____________________________Sahihi ___________
Fomu imelipiwa ada kamili _________________________________
Fomu ina hitilafu ________________________________________
Eleza hitilafu ___________________________________________
Page 1 of 8 Fomu Na. 5E(i) FOMU YA KUOMBA UKATIBU - WAZEE
Fomu Na. 5E(i)
FOMU YA KUOMBA NAFASI YA UKATIBU NDANI YA CHAMA
NGAZI YA WILAYA
BARAZA LA WAZEE CHADEMA
(Gharama ya fomu hii ni Tsh 30,000)
JIMBO _______________________ WILAYA_____________________
MKOA ________________________KANDA______________________
(Imetolewa chini ya Ibara ya 6.3.1( b), ya katiba ya chama ya mwaka
2006 toleo la mwaka 2016 na kifungu cha 4.4.7(c) cha mwongozo wa
Baraza la Wazee wa mwaka 2006 toleo la mwakma 2016)
MAELEKEZO YA UJAZAJI WA FOMU:
1. Fomu hii ijazwe kikamilifu kwa herufi kubwa kwa kutumia kalamu ya
wino mweusi/blue.
2. Fomu hii ijazwe na anayeomba kugombea.
3. Fomu hii irejeshwe na nakala (COPY) ya kadi ya uwanachama iliyolipiwa
mpaka muda ulioujaza kipengele cha (2.0) cha fomu hii, Picha za rangi
zenye muonekano wa kitambaa blue kwa nyuma, nakala za VYETI
pamoja na WASIFU (CV) ya anayeomba kugombea.
PICHA
Page 2 of 8 Fomu Na. 5E(i) FOMU YA KUOMBA UKATIBU - WAZEE
4. Fomu hii irejeshwe ikiwa na nakala (COPY) ya cheti cha kuzaliwa/kadi ya
mpiga kura/kitambulisho cha Taifa/hati ya kusafiria/leseni ya udereva.
5. Mkutano mkuu wa Baraza la wazee wa Jimbo/Wilaya
wanamamlaka ya kupendekeza tuu, KUTHIBITISHA uteuzi wa
mwisho ni ngazi ya mkoa – BARAZA LA WAZEE)
6. Kutokujaza sehemu yoyote itakuwa ni moja ya mapungufu ya fomu.
1.0 MAELEZO BINAFSI
1.1 NAFASI UNAYOOMBA KUGOMBEA______________________
MAJINA:
LA KWANZA ___________________________________________
LA PILI ___________________________________________________
LA TATU ______________________________________________
1.2 JINSIA
MWANAUME
MWANAMKE
1.3 NAMBA YA SIMU _______________________________________
BARUA PEPE __________________________________________
1.4 TAREHE YA KUZALIWA ________________
1.5 UNAPOISHI
MKOA ________________________________________________
WILAYA ______________________________________________
JIMBO ________________________________________________
KATA ________________________________________________
MJI/MANISPAA/JIJI ______________________________________
KIJIJI/MTAA ___________________________________________
MSINGI/KITONGOJI ______________________________________
1.6 URAIA
WA KUZALIWA ______________
WA KUJIANDIKISHA _____________ NAMBA __________________
Page 3 of 8 Fomu Na. 5E(i) FOMU YA KUOMBA UKATIBU - WAZEE
2.0 MAELEZO YA UANACHAMA WAKO
Tarehe ya kujiunga na Chama ____________________________
Namba ya kadi ya Uanachama ____________________________
Kadi imelipiwa mpaka Tarehe _____________________________
Tawi lako la Chama ____________________________________
Msingi wako _________________________________________
(Kama nafasi ya fomu hii haitatosha kujibu kipengele 2.1, 2.2, 3.3,
3.4, 3.5 & 3.6 weka maelezo ya kipengele husika katika
kiambatanisho
2.1 Wadhifa ndani ya CHADEMA.
Eleza kwa kifupi nyadhifa na muda uliowahi kushika nyadhifa hizo.
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
2.2 Umewahi kusimamishwa/kufukuzwa Uanachama ______________
Kama ndiyo toa maelezo, Sababu uliyofukuziwa, Lini na wapi
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
Page 4 of 8 Fomu Na. 5E(i) FOMU YA KUOMBA UKATIBU - WAZEE
3.0 MAELEZO KUHUSU UWEZO, UZOEFU NA ELIMU
Elimu ya mgombea.
Shule ya msingi____________________Kuanzia _____hadi____
Sekondari (O’level) _________________ Kuanzia_____hadi_____
Sekondari (A’level)__________________Kuanzia_____hadi_____
Chuko kikuu______________________ kuanzia_____hadi_____
Eleza cheti cha juu ulichonacho
Chuo kikuu _________________________________________
Diploma __________________________________________
Kidato ____________________________________________
Mengineyo ________________________________________
3.1 Eleza kazi unayofanya/shughuli yako halali
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
3.2 Lugha unazomudu kuzungumza (Kata isiyohusika)
Kiswahili Ndiyo/Hapana
Kingereza Ndiyo/Hapana
Nyenginezo __________________________________________
3.3 Uzoefu wa kiuongozi (Eleza kwa ufupi)
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
Page 5 of 8 Fomu Na. 5E(i) FOMU YA KUOMBA UKATIBU - WAZEE
3.4 Kabla ya kujiunga na CHADEMA uliwahi kuwa mwanachama wa
vyama /chama kingine cha siasa? __________________________
Kama ndiyo toa maelezo
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
3.5 Nini Dira, Mwelekeo na Matarajio yako ukipata wadhifa
unaouwomba?
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
Page 6 of 8 Fomu Na. 5E(i) FOMU YA KUOMBA UKATIBU - WAZEE
3.6 Je umewahi kuhukumiwa kwa kosa la jinai? __________________
Kama ndiyo toa maelezo
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
4.0 UTHIBITISHO:
Ninathibitisha kuwa maelezo niliyotoa hapo juu yote ni sahihi
Jina _________________________________________________
Sahihi _______________________________________________
Tarehe _______________________________________________
Mahali _______________________________________________
5.0 WADHAMINI WA MGOMBEA.
a) Jina kamili __________________________________________
Namba ya simu _______________________________________
Barua pepe __________________________________________
Nambari ya kadi ya chama _______________________________
Sahihi _____________
b) Jina kamili __________________________________________
Namba ya simu _______________________________________
Barua pepe __________________________________________
Nambari ya kadi ya chama _______________________________
Sahihi _____________
Page 7 of 8 Fomu Na. 5E(i) FOMU YA KUOMBA UKATIBU - WAZEE
c) Jina kamili __________________________________________
Namba ya simu _______________________________________
Barua pepe __________________________________________
Nambari ya kadi ya chama _______________________________
Sahihi ______________
d) Jina kamili __________________________________________
Namba ya simu _______________________________________
Barua pepe __________________________________________
Nambari ya kadi ya chama _______________________________
Sahihi ______________
e) Jina kamili __________________________________________
Namba ya simu _______________________________________
Barua pepe __________________________________________
Nambari ya kadi ya chama _______________________________
Sahihi ______________
f) Jina Kamili _________________________________________
Namba ya simu _______________________________________
Barua pepe __________________________________________
Nambari ya kadi ya chama _______________________________
Sahihi ______________
g) Jina Kamili _________________________________________
Namba ya simu _______________________________________
Barua pepe __________________________________________
Nambari ya kadi ya chama _______________________________
Sahihi ______________
Page 8 of 8 Fomu Na. 5E(i) FOMU YA KUOMBA UKATIBU - WAZEE
h) Jina Kamili _________________________________________
Namba ya simu _______________________________________
Barua pepe __________________________________________
Nambari ya kadi ya chama _______________________________
Sahihi ______________
i) Jina Kamili _________________________________________
Namba ya simu _______________________________________
Barua pepe __________________________________________
Nambari ya kadi ya chama _______________________________
**************************************************************
6.0 KWA MATUMIZI YA OFISI
Fomu ya maombi imepokelewa Tarehe ____________Saa _________
Aliyeipokea ____________________________________________
Nafasi/Cheo ____________________________Sahihi ___________
Fomu imelipiwa ada kamili _________________________________
Fomu ina hitilafu ________________________________________
Eleza hitilafu ___________________________________________
Page 1 of 8 Fomu Na. 5E(iii) FOMU YA KUOMBA UKATIBU - BAVICHA
Fomu Na. 5E(iii)
FOMU YA KUOMBA NAFASI YA UKATIBU NDANI YA CHAMA
NGAZI YA WILAYA
BARAZA LA VIJANA CHADEMA - BAVICHA
(Gharama ya fomu hii ni Tsh 30,000)
JIMBO _______________________ WILAYA_____________________
MKOA ________________________KANDA______________________
(Imetolewa chini ya Ibara ya 6.3.1( b), ya katiba ya chama, Katiba ya
mwaka 2006 toleo la mwaka 2016)
MAELEKEZO YA UJAZAJI WA FOMU:
1. Fomu hii ijazwe kikamilifu kwa herufi kubwa kwa kutumia kalamu ya
wino mweusi/blue.
2. Fomu hii ijazwe na anayeomba kugombea.
3. Kutokujaza sehemu yoyote itakuwa ni moja ya mapungufu ya fomu
4. Fomu hii irejeshwe na nakala (COPY) ya kadi ya uwanachama iliyolipiwa
mpaka muda ulioujaza kipengele cha (2.0) cha fomu hii, Picha za rangi
zenye muonekano wa kitambaa blue kwa nyuma, nakala za VYETI
pamoja na WASIFU (CV) ya anayeomba kugombea.
5. Fomu hii irejeshwe ikiwa na nakala (COPY) ya cheti cha kuzaliwa/kadi ya
mpiga kura/kitambulisho cha Taifa/hati ya kusafiria/leseni ya udereva
PICHA
Page 2 of 8 Fomu Na. 5E(iii) FOMU YA KUOMBA UKATIBU - BAVICHA
1.0 MAELEZO BINAFSI
1.1 NAFASI UNAYOOMBA KUGOMBEA______________________
MAJINA:
LA KWANZA ___________________________________________
LA PILI ___________________________________________________
LA TATU ______________________________________________
1.2 JINSIA
MWANAUME
MWANAMKE
1.3 NAMBA YA SIMU _______________________________________
BARUA PEPE __________________________________________
1.4 TAREHE YA KUZALIWA ________________
1.5 UNAPOISHI
MKOA ________________________________________________
WILAYA ______________________________________________
JIMBO ________________________________________________
KATA ________________________________________________
MJI/MANISPAA/JIJI ______________________________________
KIJIJI/MTAA ___________________________________________
MSINGI/KITONGOJI ______________________________________
1.6 URAIA
WA KUZALIWA ______________
WA KUJIANDIKISHA _____________ NAMBA __________________
2.0 MAELEZO YA UANACHAMA WAKO
Tarehe ya kujiunga na Chama ____________________________
Namba ya kadi ya Uanachama ____________________________
Kadi imelipiwa mpaka Tarehe _____________________________
Tawi lako la Chama ____________________________________
Msingi wako _________________________________________
Page 3 of 8 Fomu Na. 5E(iii) FOMU YA KUOMBA UKATIBU - BAVICHA
(Kama nafasi ya fomu hii haitatosha kujibu kipengele 2.1, 2.2, 3.3,
3.4, 3.5 & 3.6 weka maelezo ya kipengele husika katika
kiambatanisho
2.1 Wadhifa ndani ya CHADEMA.
Eleza kwa kifupi nyadhifa na muda uliowahi kushika nyadhifa hizo.
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
2.2 Umewahi kusimamishwa/kufukuzwa Uanachama ______________
Kama ndiyo toa maelezo, Sababu uliyofukuziwa, Lini na wapi
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
Page 4 of 8 Fomu Na. 5E(iii) FOMU YA KUOMBA UKATIBU - BAVICHA
3.0 MAELEZO KUHUSU UWEZO, UZOEFU NA ELIMU
Elimu ya mgombea.
Shule ya msingi____________________Kuanzia _____hadi____
Sekondari (O’level) _________________ Kuanzia_____hadi_____
Sekondari (A’level)__________________Kuanzia_____hadi_____
Chuko kikuu______________________ kuanzia_____hadi_____
Eleza cheti cha juu ulichonacho
Chuo kikuu _________________________________________
Diploma __________________________________________
Kidato ____________________________________________
Mengineyo ________________________________________
3.1 Eleza kazi unayofanya/shughuli yako halali
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
3.2 Lugha unazomudu kuzungumza (Kata isiyohusika)
Kiswahili Ndiyo/Hapana
Kingereza Ndiyo/Hapana
Nyenginezo __________________________________________
3.3 Uzoefu wa kiuongozi (Eleza kwa ufupi)
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
Page 5 of 8 Fomu Na. 5E(iii) FOMU YA KUOMBA UKATIBU - BAVICHA
3.4 Kabla ya kujiunga na CHADEMA uliwahi kuwa mwanachama wa
vyama /chama kingine cha siasa? __________________________
Kama ndiyo toa maelezo
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
3.5 Nini Dira, Mwelekeo na Matarajio yako ukipata wadhifa
unaouwomba?
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
Page 6 of 8 Fomu Na. 5E(iii) FOMU YA KUOMBA UKATIBU - BAVICHA
3.6 Je umewahi kuhukumiwa kwa kosa la jinai? __________________
Kama ndiyo toa maelezo
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
4.0 UTHIBITISHO:
Ninathibitisha kuwa maelezo niliyotoa hapo juu yote ni sahihi
Jina _________________________________________________
Sahihi _______________________________________________
Tarehe _______________________________________________
Mahali _______________________________________________
5.0 WADHAMINI WA MGOMBEA.
a) Jina kamili __________________________________________
Namba ya simu _______________________________________
Barua pepe __________________________________________
Nambari ya kadi ya chama _______________________________
Sahihi _____________
b) Jina kamili __________________________________________
Namba ya simu _______________________________________
Barua pepe __________________________________________
Nambari ya kadi ya chama _______________________________
Sahihi _____________
Page 7 of 8 Fomu Na. 5E(iii) FOMU YA KUOMBA UKATIBU - BAVICHA
c) Jina kamili __________________________________________
Namba ya simu _______________________________________
Barua pepe __________________________________________
Nambari ya kadi ya chama _______________________________
Sahihi ______________
d) Jina kamili __________________________________________
Namba ya simu _______________________________________
Barua pepe __________________________________________
Nambari ya kadi ya chama _______________________________
Sahihi ______________
e) Jina kamili __________________________________________
Namba ya simu _______________________________________
Barua pepe __________________________________________
Nambari ya kadi ya chama _______________________________
Sahihi ______________
f) Jina Kamili _________________________________________
Namba ya simu _______________________________________
Barua pepe __________________________________________
Nambari ya kadi ya chama _______________________________
Sahihi ______________
g) Jina Kamili _________________________________________
Namba ya simu _______________________________________
Barua pepe __________________________________________
Nambari ya kadi ya chama _______________________________
Sahihi ______________
Page 8 of 8 Fomu Na. 5E(iii) FOMU YA KUOMBA UKATIBU - BAVICHA
h) Jina Kamili _________________________________________
Namba ya simu _______________________________________
Barua pepe __________________________________________
Nambari ya kadi ya chama _______________________________
Sahihi ______________
i) Jina Kamili _________________________________________
Namba ya simu _______________________________________
Barua pepe __________________________________________
Nambari ya kadi ya chama _______________________________
**************************************************************
6.0 KWA MATUMIZI YA OFISI
Fomu ya maombi imepokelewa Tarehe ____________Saa _________
Aliyeipokea ____________________________________________
Nafasi/Cheo ____________________________Sahihi ___________
Fomu imelipiwa ada kamili _________________________________
Fomu ina hitilafu ________________________________________
Eleza hitilafu ___________________________________________
Page 1 of 8 Fomu Na 6E(i) (KUOMBA UONGOZI NDANI YA CHAMA - WAZEE)
Fomu Na. 6E(i)
FOMU YA KUOMBA NAFASI YA UONGOZI NDANI YA CHAMA
NGAZI YA WILAYA
BARAZA LA WAZEE CHADEMA
(Gharama ya fomu hii ni Tsh 30,000)
JIMBO _______________________WILAYA______________________
MKOA________________________KANDA ______________________
(Imetolewa chini ya Ibara ya 6.3.1( b) ya katiba ya chama na Kanuni ya
(7.2.3) ya kanuni za chama. Katiba ya mwaka 2006 toleo la mwaka
2016)
A. MAELEKEZO YA UJAZAJI WA FOMU:
1. Fomu hii ijazwe kikamilifu kwa herufi kubwa kwa kutumia kalamu ya
wino mweusi/blue.
2. Kutokujaza sehemu yoyote itakuwa ni moja ya mapungufu ya fomu.
3. Fomu hii ijazwe na anayeomba kugombea.
4. Fomu hii irejeshwe na nakala (COPY) ya kadi ya uwanachama iliyolipiwa
mpaka muda ulioujaza kipengele cha (2.0) cha fomu hii.
5. Fomu hii irejeshwe ikiwa na picha ya anayeomba nafasi ya kugombea
yenye muonekano wa kitambaa cha blue kwa nyuma
6. Fomu hii irejeshwe ikiwa na nakala (COPY) ya cheti cha kuzaliwa/kadi ya
mpiga kura/kitambulisho cha Taifa/hati ya kusafiria/leseni ya udereva
PICHA
Page 2 of 8 Fomu Na 6E(i) (KUOMBA UONGOZI NDANI YA CHAMA - WAZEE)
1.0 MAELEZO BINAFSI
1.1 NAFASI UNAYOOMBA KUGOMBEA______________________
MAJINA:
LA KWANZA ___________________________________________
LA PILI ___________________________________________________
LA TATU ______________________________________________
1.2 JINSIA
MWANAUME
MWANAMKE
1.3 NAMBA YA SIMU _______________________________________
BARUA PEPE __________________________________________
1.4 TAREHE YA KUZALIWA ________________
1.5 UNAPOISHI
MKOA ________________________________________________
WILAYA ______________________________________________
JIMBO ________________________________________________
KATA ________________________________________________
MJI/MANISPAA/JIJI ______________________________________
KIJIJI/MTAA ___________________________________________
MSINGI/KITONGOJI ______________________________________
1.6 URAIA
WA KUZALIWA ______________
WA KUJIANDIKISHA _____________ NAMBA __________________
2.0 MAELEZO YA UANACHAMA WAKO
Tarehe ya kujiunga na Chama ____________________________
Namba ya kadi ya Uanachama ____________________________
Kadi imelipiwa mpaka Tarehe _____________________________
Tawi lako la Chama ____________________________________
Msingi wako _________________________________________
Page 3 of 8 Fomu Na 6E(i) (KUOMBA UONGOZI NDANI YA CHAMA - WAZEE)
(Kama nafasi ya fomu hii haitatosha kujibu kipengele 2.1, 2.2, 3.3,
3.4, 3.5 & 3.6 weka maelezo ya kipengele husika katika
kiambatanisho
2.1 Wadhifa ndani ya CHADEMA.
Eleza kwa kifupi nyadhifa na muda uliowahi kushika nyadhifa hizo.
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
2.2 Umewahi kusimamishwa/kufukuzwa Uanachama ______________
Kama ndiyo toa maelezo, Sababu uliyofukuziwa, Lini na wapi
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
3.0 MAELEZO KUHUSU UWEZO, UZOEFU NA ELIMU
Elimu ya mgombea.
Shule ya msingi____________________Kuanzia _____hadi____
Sekondari (O’level) _________________ Kuanzia_____hadi_____
Sekondari (A’level)__________________Kuanzia_____hadi_____
Chuko kikuu______________________ kuanzia_____hadi_____
Page 4 of 8 Fomu Na 6E(i) (KUOMBA UONGOZI NDANI YA CHAMA - WAZEE)
Eleza cheti cha juu ulichonacho
Chuo kikuu _________________________________________
Diploma __________________________________________
Kidato ____________________________________________
Mengineyo ________________________________________
3.1 Eleza kazi unayofanya/shughuli yako halali
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
3.2 Lugha unazomudu kuzungumza (Kata isiyohusika)
Kiswahili Ndiyo/Hapana
Kingereza Ndiyo/Hapana
Nyenginezo __________________________________________
3.3 Uzoefu wa kiuongozi (Eleza kwa ufupi)
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
Page 5 of 8 Fomu Na 6E(i) (KUOMBA UONGOZI NDANI YA CHAMA - WAZEE)
3.4 Kabla ya kujiunga na CHADEMA uliwahi kuwa mwanachama wa
vyama /chama kingine cha siasa? __________________________
Kama ndiyo toa maelezo
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
3.5 Nini Dira, Mwelekeo na Matarajio yako ukipata wadhifa
unaouwomba?
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
Page 6 of 8 Fomu Na 6E(i) (KUOMBA UONGOZI NDANI YA CHAMA - WAZEE)
3.6 Je umewahi kuhukumiwa kwa kosa la jinai? __________________
Kama ndiyo toa maelezo
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
4.0 UTHIBITISHO:
Ninathibitisha kuwa maelezo niliyotoa hapo juu yote ni sahihi
Jina _________________________________________________
Sahihi _______________________________________________
Tarehe _______________________________________________
Mahali _______________________________________________
5.0 WADHAMINI WA MGOMBEA
a) Jina kamili __________________________________________
Namba ya simu _______________________________________
Barua pepe __________________________________________
Nambari ya kadi ya chama _______________________________
Sahihi _____________
b) Jina kamili __________________________________________
Namba ya simu _______________________________________
Barua pepe __________________________________________
Nambari ya kadi ya chama _______________________________
Sahihi _____________
Page 7 of 8 Fomu Na 6E(i) (KUOMBA UONGOZI NDANI YA CHAMA - WAZEE)
c) Jina kamili __________________________________________
Namba ya simu _______________________________________
Barua pepe __________________________________________
Nambari ya kadi ya chama _______________________________
Sahihi ______________
d) Jina kamili __________________________________________
Namba ya simu _______________________________________
Barua pepe __________________________________________
Nambari ya kadi ya chama _______________________________
Sahihi ______________
e) Jina kamili __________________________________________
Namba ya simu _______________________________________
Barua pepe __________________________________________
Nambari ya kadi ya chama _______________________________
Sahihi ______________
f) Jina kamili __________________________________________
Namba ya simu _______________________________________
Barua pepe __________________________________________
Nambari ya kadi ya chama _______________________________
Sahihi ______________
g) Jina kamili __________________________________________
Namba ya simu _______________________________________
Barua pepe __________________________________________
Nambari ya kadi ya chama _______________________________
Sahihi ______________
Page 8 of 8 Fomu Na 6E(i) (KUOMBA UONGOZI NDANI YA CHAMA - WAZEE)
h) Jina kamili __________________________________________
Namba ya simu _______________________________________
Barua pepe __________________________________________
Nambari ya kadi ya chama _______________________________
Sahihi ______________
i) Jina kamili __________________________________________
Namba ya simu _______________________________________
Barua pepe __________________________________________
Nambari ya kadi ya chama _______________________________
**************************************************************
6.0 KWA MATUMIZI YA OFISI
Fomu ya maombi imepokelewa Tarehe ____________Saa _________
Aliyeipokea ____________________________________________
Nafasi/Cheo ____________________________Sahihi ___________
Fomu imelipiwa ada kamili _________________________________
Fomu ina hitilafu ________________________________________
Eleza hitilafu ___________________________________________
Page 1 of 8 Fomu Na 6E(iii) (KUOMBA UONGOZI NDANI YA CHAMA -BAVICHA)
Fomu Na. 6E(iii)
FOMU YA KUOMBA NAFASI YA UONGOZI NDANI YA CHAMA
NGAZI YA WILAYA
BARAZA LA VIJANA CHADEMA - BAVICHA
(Gharama ya fomu hii ni Tsh 30,000)
JIMBO _______________________WILAYA______________________
MKOA________________________KANDA ______________________
(Imetolewa chini ya Ibara ya 6.3.1( b) ya katiba ya chama na Kanuni ya
(7.2.3) ya kanuni za chama. Katiba ya mwaka 2006 toleo la mwaka
2016)
A. MAELEKEZO YA UJAZAJI WA FOMU:
1. Fomu hii ijazwe kikamilifu kwa herufi kubwa kwa kutumia kalamu ya
wino mweusi/blue.
2. Kutokujaza sehemu yoyote itakuwa ni moja ya mapungufu ya fomu.
3. Fomu hii ijazwe na anayeomba kugombea.
4. Fomu hii irejeshwe na nakala (COPY) ya kadi ya uwanachama iliyolipiwa
mpaka muda ulioujaza kipengele cha (2.0) cha fomu hii.
5. Fomu hii irejeshwe ikiwa na picha ya anayeomba nafasi ya kugombea
yenye muonekano wa kitambaa cha blue kwa nyuma
6. Fomu hii irejeshwe ikiwa na nakala (COPY) ya cheti cha kuzaliwa/kadi ya
mpiga kura/kitambulisho cha Taifa/hati ya kusafiria/leseni ya udereva
PICHA
Page 2 of 8 Fomu Na 6E(iii) (KUOMBA UONGOZI NDANI YA CHAMA -BAVICHA)
1.0 MAELEZO BINAFSI
1.1 NAFASI UNAYOOMBA KUGOMBEA______________________
MAJINA:
LA KWANZA ___________________________________________
LA PILI ___________________________________________________
LA TATU ______________________________________________
1.2 JINSIA
MWANAUME
MWANAMKE
1.3 NAMBA YA SIMU _______________________________________
BARUA PEPE __________________________________________
1.4 TAREHE YA KUZALIWA ________________
1.5 UNAPOISHI
MKOA ________________________________________________
WILAYA ______________________________________________
JIMBO ________________________________________________
KATA ________________________________________________
MJI/MANISPAA/JIJI ______________________________________
KIJIJI/MTAA ___________________________________________
MSINGI/KITONGOJI ______________________________________
1.6 URAIA
WA KUZALIWA ______________
WA KUJIANDIKISHA _____________ NAMBA __________________
2.0 MAELEZO YA UANACHAMA WAKO
Tarehe ya kujiunga na Chama ____________________________
Namba ya kadi ya Uanachama ____________________________
Kadi imelipiwa mpaka Tarehe _____________________________
Tawi lako la Chama ____________________________________
Msingi wako _________________________________________
Page 3 of 8 Fomu Na 6E(iii) (KUOMBA UONGOZI NDANI YA CHAMA -BAVICHA)
(Kama nafasi ya fomu hii haitatosha kujibu kipengele 2.1, 2.2, 3.3,
3.4, 3.5 & 3.6 weka maelezo ya kipengele husika katika
kiambatanisho
2.1 Wadhifa ndani ya CHADEMA.
Eleza kwa kifupi nyadhifa na muda uliowahi kushika nyadhifa hizo.
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
2.2 Umewahi kusimamishwa/kufukuzwa Uanachama ______________
Kama ndiyo toa maelezo, Sababu uliyofukuziwa, Lini na wapi
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
3.0 MAELEZO KUHUSU UWEZO, UZOEFU NA ELIMU
Elimu ya mgombea.
Shule ya msingi____________________Kuanzia _____hadi____
Sekondari (O’level) _________________ Kuanzia_____hadi_____
Sekondari (A’level)__________________Kuanzia_____hadi_____
Chuko kikuu______________________ kuanzia_____hadi_____
Page 4 of 8 Fomu Na 6E(iii) (KUOMBA UONGOZI NDANI YA CHAMA -BAVICHA)
Eleza cheti cha juu ulichonacho
Chuo kikuu _________________________________________
Diploma __________________________________________
Kidato ____________________________________________
Mengineyo ________________________________________
3.1 Eleza kazi unayofanya/shughuli yako halali
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
3.2 Lugha unazomudu kuzungumza (Kata isiyohusika)
Kiswahili Ndiyo/Hapana
Kingereza Ndiyo/Hapana
Nyenginezo __________________________________________
3.3 Uzoefu wa kiuongozi (Eleza kwa ufupi)
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
Page 5 of 8 Fomu Na 6E(iii) (KUOMBA UONGOZI NDANI YA CHAMA -BAVICHA)
3.4 Kabla ya kujiunga na CHADEMA uliwahi kuwa mwanachama wa
vyama /chama kingine cha siasa? __________________________
Kama ndiyo toa maelezo
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
3.5 Nini Dira, Mwelekeo na Matarajio yako ukipata wadhifa
unaouwomba?
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
Page 6 of 8 Fomu Na 6E(iii) (KUOMBA UONGOZI NDANI YA CHAMA -BAVICHA)
3.6 Je umewahi kuhukumiwa kwa kosa la jinai? __________________
Kama ndiyo toa maelezo
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
4.0 UTHIBITISHO:
Ninathibitisha kuwa maelezo niliyotoa hapo juu yote ni sahihi
Jina _________________________________________________
Sahihi _______________________________________________
Tarehe _______________________________________________
Mahali _______________________________________________
5.0 WADHAMINI WA MGOMBEA
a) Jina kamili __________________________________________
Namba ya simu _______________________________________
Barua pepe __________________________________________
Nambari ya kadi ya chama _______________________________
Sahihi _____________
b) Jina kamili __________________________________________
Namba ya simu _______________________________________
Barua pepe __________________________________________
Nambari ya kadi ya chama _______________________________
Sahihi _____________
Page 7 of 8 Fomu Na 6E(iii) (KUOMBA UONGOZI NDANI YA CHAMA -BAVICHA)
c) Jina kamili __________________________________________
Namba ya simu _______________________________________
Barua pepe __________________________________________
Nambari ya kadi ya chama _______________________________
Sahihi ______________
d) Jina kamili __________________________________________
Namba ya simu _______________________________________
Barua pepe __________________________________________
Nambari ya kadi ya chama _______________________________
Sahihi ______________
e) Jina kamili __________________________________________
Namba ya simu _______________________________________
Barua pepe __________________________________________
Nambari ya kadi ya chama _______________________________
Sahihi ______________
f) Jina kamili __________________________________________
Namba ya simu _______________________________________
Barua pepe __________________________________________
Nambari ya kadi ya chama _______________________________
Sahihi ______________
g) Jina kamili __________________________________________
Namba ya simu _______________________________________
Barua pepe __________________________________________
Nambari ya kadi ya chama _______________________________
Sahihi ______________
Page 8 of 8 Fomu Na 6E(iii) (KUOMBA UONGOZI NDANI YA CHAMA -BAVICHA)
h) Jina kamili __________________________________________
Namba ya simu _______________________________________
Barua pepe __________________________________________
Nambari ya kadi ya chama _______________________________
Sahihi ______________
i) Jina kamili __________________________________________
Namba ya simu _______________________________________
Barua pepe __________________________________________
Nambari ya kadi ya chama _______________________________
**************************************************************
6.0 KWA MATUMIZI YA OFISI
Fomu ya maombi imepokelewa Tarehe ____________Saa _________
Aliyeipokea ____________________________________________
Nafasi/Cheo ____________________________Sahihi ___________
Fomu imelipiwa ada kamili _________________________________
Fomu ina hitilafu ________________________________________
Eleza hitilafu ___________________________________________
