A. Personal Details Surname: First Name Other Name
ID/Passport No.: Date of Birth (dd/mm/yyyy): Marital Status: Gender:MaleFemale
Postal Address.: Postal Code: Town: County: Sub County: Ward:
Location: Sub Location: Village: Nemis Code: KRA PIN:
Mobile Number Your email: Nationality:
Do you have any disability:NoYes if Yes, Then specify (give details)
B. Academic Qualifications SCHOOL/COLLEGE ATTENDEDINDEX NUMBERYEAR EXAMINEDMEAN GRADE/MARKS COLLEGE KCSE KCPE
C. Sponsorship/Guardian Details Full Name: Postal Address: Postal Code: Town: Relationship to Applicant: Email Address: Mobile Number: Occupation:
D. Course Details Course Name in Full: Intake:JANMAYSEPT Level (Tick one):ARTISANCRAFTDIPLOMA Program Duration: Examining Body: Type of Application(Tick one):KUCCPSDIRECT
E. Upload Documents Upload KCSE Certificate Upload KCPE Certificate Upload National ID Upload Birth Certificate Upload Coloured Passport
F. Confirmation I confirm the information given above is correct to the best of my knowledge and do take full responsibility for any incorrect information Click here to confirm that you accept the stated terms and conditions
