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Applicant's Personal Details
   
Surname*
Others Names*
Date of Birth*
Gender*
Home Village*
Sub county*
Home District*
Permanent Address*
E-mail address:
Phone number 1:*
Phone number 2:
Alternative contact:
Physical Address
Country of Residence*
Do you have disability*
Particulars of the Programme Applied for
1st Choice*
2nd Choice*
3rd Choice*
1st Choice*
2nd Choice*
3rd Choice*
Information on Parents
a) Father
Name*
Contact
Current Residential Address
Village & Sub county of Birth
District of Birth
Nationality*
Country of Residence
b) Mother
Name*
Contact
Current Residential Address
Village & Sub county of Birth
District of Birth
Nationality*
Country of Residence
Academic Documents, Certificates or any other relevant documents
  O-level slip*
  A-level slip*
  Transcript
  Birth Certificate*
  Nationa ID/School ID
  Bank slip*
Important: Applicants should note the following:
  • Softcopies of the both "O" and "A" level results, certificates or any other relevant documents plus birth certificate must be attached.
  • This application form will only be accepted by the Academic Registar if accompanied with a receipt showing payment of the required registration fee.
  • When discovered, impersonation, uttering of false documents or false/incomplete information will lead to cancellation of admission and possible legal action.
   
 
   
 
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