Beruflich Dokumente
Kultur Dokumente
PLEASE NOTE
1. Application forms are available Free of Charge at the NG-Kiambu CDF office & other designated
points.
2. The following documents MUST be attached to the application form.
a) Fees structure for the current academic year
b) Latest results transcript
c) Death certificate (For Orphans and students whose any of the parents is deceased)
d) Copy of voters card
e) Any other relevant supporting documents
3. The bursary form should be returned to the NG-Kiambu CDF office on or before 9th March 2018
A. PERSONAL INFORMATION
Name of Applicant: ……………………………………………………………………………………………………………………………
Sex: Female ( ) Male ( ) Date of Birth ………………………………………………………………………..
Sub County:. …………………………………………..Ward …………………………………………………………………………………
Location:………………………………………………Sub-Location: ………………………………………………………………………
Address: ……………………………………………….Phone No: …………………………………………………………………………..
B. INSTITUTION INFORMATION
Name of Institution ………………………………………………………………………………………………………………..…………
Reg. /Adm. No. …………………………….…………………Year/Form 1( ) 2( ) 3( ) 4( ) Others …………….
Course taken……………………………………………………………………. Duration ………………………………………………….
C. FEES DETAILS
(a) Fees for the (b) Previous Term/year (s) (c)Amount paid/Able to pay in Balance =
Current Term outstanding balance the current term - Including (a) + (b) – (c)
Funds from Other Financiers
D. FAMILY INFORMATION
STUDENT’S DECLARATION
I declare that the information given here in is true to the best of my knowledge.
Student Signature ……………………………………………. Date ……………………………………………………………………….
PARENT/GUARDIAN’S DECLARATION
I declare that I understand the contents of this form and that the information given here in is true to
the best of my knowledge and belief
Parent/Guardian’s Signature…………………………………………….. Date ………………………………………………..
SCHOOL’S CERTIFICATION
I confirm that the applicant is a registered student in this school and that the information given here
in above regarding school fees and performance is true
Signature ……………………………………………………..….Date………………………………………………………………….
Name ………………………………………………………….……Designation………………………………………………………
School’s Official Stamp …………………………………………………………………………………………………………………
Remarks ……………………………………………………………………………………………………………………………..........
……………………………………………………………………………………………………………………………………………………
CHIEF/RELIGIOUS LEADER’S CERTIFICATION
I certify that the personal and family information given here in is correct
Signature………………………………………………………..Date……………………………………………………………………
Name……………………………………………………………..Designation ………………………………………………………..
Official Stamp ……………………………………………………………………………………………………………………………..
Remarks ……………………………………………………………………………………………………………………………………..
Reason(s) …………………………………………………………………………………………………………………………………..
…………………………………………………………………………………………………………………………………………………..