PRIVATELY SPONSORED STUDENTS PROGRAMME (PSSP) FORM

Maasai Mara University
OFFICIAL USE ONLY
Receipt No
Serial No
PRIVATELY SPONSORED STUDENTS PROGRAMME (PSSP)

APPLICATION FOR ADMISSION - CERTIFICATE, DIPLOMA AND UNDERGRADUATE PROGRAMMES
i. This form should be completed in BLOCK LETTERS and returned to the Admissions Office, Maasai Mara University P.O. Box 861 - 20500, NAROK.

ii. Attach copies of your academic and professional certificates, transcripts and where applicable, your current appointment letter.

iii. Attach copies of your national identity card, passport or birth certificate.

iv. Duly completed forms must be returned with a payment of a non refundable application fee of Kshs. 1,000 for Degree programmes and Ksh. 500 for Diploma and Certificate programmes. Payments should be deposited into any of the following accounts: Co-operative Bank ltd, Narok Branch (01129337192600) or Equity Bank, Narok (0360292999764 Original bank pay in slip, bankers cheque or money orders MUST be attached to the application form.
SCHOOL OF *
I. PERSONAL DATA
APPLICANT'S NAME
Surname
Middle Name
First Name
CONTACT (POSTAL ADDRESS)
POSTAL CODE
TELEPHONE
E-MAIL
DATE OF BIRTH
GENDER

MALE FEMALE
NATIONALITY
NATIONAL ID./ PASSPORT NO
COUNTY
MARITAL STATUS : (Tick as appropriate)

SINGLE MARRIED
II.DEGREE/ DIPLOMA/ CERTIFICATE APPLIED FOR
e.g. Business Management, social work, etc
III. CAMPUS
IV. ACADEMIC YEAR
e.g. 2011/2012
V. INTAKE
e.g. January, April, May, August
MODE OF STUDY : (Tick as appropriate)

Full time Part-time Weekend Weekend Holiday

RECORDS OF SECONDARY EDUCATION (Attach copies of Result slips and Certificates)

	SCHOOL	FROM (YEAR)	TO (YEAR)	CERTIFICATE	OBTAINED
1
2
3

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POST SECONDARY EDUCATION (Attach copies of Result slips and Certificates)

	INSTITUTION/POLY/UNIVERSITY	FROM (YEAR)	TO (YEAR)	AREA OF STUDY	QUALIFICATIONS
1
2
3

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WORK/PROFESSIONALISM

	JOB TITLE	EMPLOYER	FROM	TO
1
2
3

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FINANCES
Please indicate how you intend to finance your study (Tick as appropriate)

Private finance source Other financial sources
How did you learn about Maasai Mara Univresity? Please tick appropriately.

Newspaper Former/ Current student Radio Television University College Website Other Exhibitions (Specify) Commission for Higher Education Exhibitions Others (Please Specify)
Others (Please Specify)
EXEMPTIONS (To be filled by applicants who wish to be considered for Exemptions) Please specify the qualifications which the exemptions will be based;

Diploma/Higher National Diploma Professional Qualifications e.g. CPA
Other (Please specify)
I certify that the information given in this form is correct to the best of my knowledge.
Signature of Applicant

Clear
Date

Month Day Year
Date
FOR OFFICIAL USE
a) Dean of School
Admission

Recommended Not Recommended
Programme
To Begin In Year
Semester
Comments
Deans Name
Signature

Clear
Date

Month Day Year
b) Registrar (Academic Affairs)
Admission

Approved Not Approved
Comments
Registrar's Signature

Clear
Date

Month Day Year
Should be Empty:

Maasai Mara University

OFFICIAL USE ONLY

PRIVATELY SPONSORED STUDENTS PROGRAMME (PSSP)

I. PERSONAL DATA

APPLICANT'S NAME