Students Registration Form

Online Application Form

Please fill out the application form carefully and completely
- Full Name
  
  First NameMiddle NameLast Name
- Gender
- Birth Date
  
  MonthDayYear
- Course/Programme Applying for:
  for Incoming A.Y. '12-'13
- Mode of Study
- E-mail
  ex: webmaster@gluk.ac.ke
- Phone Number 1
  
  Country CodePhone Number
- Phone Number 2
  
  Country CodePhone Number
- Student Index Number/National ID
  e.g. 11183021
- County of Residence
  for Incoming A.Y. '12-'13
- Marital Status
- Nationality
- Religion
- Present Address
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip CodeCountry
- Person to contact in case of emergency:
  Parent/Guardian - (Phone Number)
- Relationship
  ex. Father, Mother, etc.
- High School Name
- Mean Grade
- Academic Certs
  
  Upload a File
  File should be in pdf, doc/docx format. Cancelof
- Mathematics
- English
- Kiswahili
- Physics
- Chemistry
- Biology
- Geography
- History
- Agriculture
- CRE/IRE
- Business
- Other Subject (please indicate the subject with the grade)
- Extra Curricular Participation
- Bank Slip Attachment
  
  Upload a File
  File should be in pdf, doc/docx format. Cancelof
- Skills/Talents
- Other Skills/talents
- Sports
- Other Sports
- How did you hear about us?
- Do you have any scholarship?
- If Yes, who/what is the name of your sponsor?
- Do you plan to shift to another course?
- If Yes, to what course?
- Suggestions / Comments
- Enter the words shown:
- Should be Empty:

Online Application Form