Student Application Form

Complete the form below to submit your application to our admissions office.

Important: All fields marked with * are required.

Personal Data

Full Names *

ID/Passport No. *

Date of Birth *

Phone No. *

Email Address *

Nationality *

Disability Status

No Yes

Full Name *

Phone No. *

Relationship *

Secondary School Name

KCSE Mean Grade

Year From

Year To

Course Applied For *

Intake Year *

Intake Month *

Who will sponsor your education? *

Self Parents Self & Parents Others

How did you learn about us?

Full Name (as signature) *

Date *