O LEVEL APPLICATION TO ADMIN SMAGOK

CALL: +256702 478 536 +256702 564 109

kmariagoretti@yahoo.com www.stmariagorettik.ac.ug
S.1 LEVEL APPLICATION FORM
APPLICANT
FULL NAME*
DATE OF BIRTH*

MonthDayYear
Date
FORMER SCHOOL*
RELIGION*
NATIONALITY*
HOME DISTRICT*
TELEPHONE NUMBERS:
Phone Number*
Please enter a valid phone number.
Phone Number*
Please enter a valid phone number.
EMAIL*
SCORES IN PLE
SCIENCE*
MATH*
SST*
ENGLISH*
DIVISION*
AGGREGATE*
INTERESTS/HOBBIES*
FOR THE PARENTS OR GUARDIANS
PARENTS/GUARDIANS NAME*
PARENTS /GUARDIAN'S OCCUPATION*
ADDRESS*
CONTACT*
EMAIL*
A. HEALTH (mention special defects e.g eye sight, hearing, asthma, if possible please present a current medical report)*
B. A candidate will be disqualified at any stage if found to have filled false information to this form

APPLICANTS SIGNATURE PARENTS/GUARDIANS SIGNITURE
FOR OFFICIAL USE ONLY
Have you picked your admission from school yet?
Should be Empty:

CALL: +256702 478 536 +256702 564 109