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STUDENT APPLICATION FORM
NOTES

You are required to fill this form with all your details. please attach scanned copies of your academic papers
Please note

Please note that your admission will be processed upon verification of payment of 50,000 shs application fee .

Personal Details
NAMES*
Date of Birth*
NATIONALITY*
DISTRICT*
GENDER*

MaleFemale
CONTACT*
Please enter a valid phone number eg. (070) 000-0000
EMAIL*
example@example.com
MARITAL STATUS*

MarriedSingleDivorcedOther
RELIGION*
ANY DISABILITY?*

YesNo
NEXT OF KIN*

First NameLast Name

Documents
NATIONAL ID*

Scanned pdf file
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O'LEVEL SCHOOL *
Enter your Lower Secondary school Name
O'LEVEL PASS-SLIP*

Upload scanned pdf file of O'level Pass-slip
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OTHER QUALIFICATIONS*

Upload pdf certificates, transcript etc
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A'LEVEL/HIGH SCHOOL *
Enter High school name
A'LEVEL/HIGH SCHOOL DOCUMENTS*

Upload a pdf file of A'level pass-slip or Certificate
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STUDY TYPE*
SELECT INTAKE*
ACADEMIC YEAR*

PARENT/GUARDIAN DETAILS
COURSE APPLIED FOR*
NAMES*

First NameLast Name
NATIONALITY*
OCCUPATION*
CONTACT*
Please enter Valid Number

Pay Application Fees

Option 1. For MTN MoMO, Press *165*4*3#, Select school pay(2) then school fees(1) , enter this code( 9900195329). upon payment, you will receive message, please enter the transaction ID in the space provided.
Option 2

For Airtel Money, Press *185*6*2#, Select pay fees(1) , enter this code( 9900195329). upon payment, you will receive message, please enter the transaction ID in the space provided
PAYMENT ID*
Should be Empty: