STUDENT’S ADMISSION FORM 1. Full Names as on KCPE Certificate..............................................…………...............................................

2. K.C.P.E. INDEX NO. (in full) .......................................................K.C.P.E. Marks....................................

3. Date of Birth.............................................................................................…………................................

4. Family Information. (Please specify the occupation clearly)

Name Occupation Address Mobile No

Father

Mother

Guardian

5. Local Government

County....................................... Sub-county.............................................. Division……………….……………

Location.................................... Sub-Location........................................... Village…………….….………..……

6. Address of person(s) responsible for your school fees

NAME Address Mobile No Relationship

7. Siblings

No Name Age Sex School / Occupation 1 2 3

8. School Background

List of schools attended to date

1 ………………………………………………………………………………………….

2 ………………………………………………………………………………………….

3 …………………………………………………………………………………………..