Scholarships

REPUBLIC OF KENYA
MINISTRY OF HIGHER EDUCATION, SCIENCE AND TECHNOLOGY

(SCHOLARSHIP TITLE)

(NAME OF COUNTRY WHERE TENABLE)

1. Name in full ______________________________________________________
(Surname)
(Others)
2. Present mailing address ____________________________________________
3. Present contact
(a) Telephone
(i) Landline: __________________________________________________
(ii) Mobile Phone No. ____________________________________________
(b) Permanent Address _____________________________________________
(c) Email _________________________________________________________
4. Age ______________Date of Birth ___________________ Sex ____________
5. Home Province ___________________________________________________
District __________________________________________________________
Division _________________________________________________________
6. Employers Details (if applicable)
Name ___________________________________________________________
Address _________________________________________________________
Telephone _______________________________________________________
Designation ______________________________________________________

7. Do you have any dependants? ______ if yes, who will support them if you are
offered a scholarship? ______________________________________________
8. What course do you wish to study? ____________________________________

9. Proposed future profession in Kenya ___________________________________
10. Schools or college presently attending _________________________________

11. Do you plan to sit for any examination this year? _________________________
If yes, give details _________________________________________________

12. Have you applied for admission into any institution of higher learning in Kenya?
If yes, give details _________________________________________________
________________________________________________________________
13. Have you received a scholarship in the last two years? ____________________
If yes, state the sponsor and scholarship title ____________________________
________________________________________________________________
14. Institutions attended

Date

Qualification

(i) _____________________

______________

_____________________

(ii) _____________________

______________

_____________________

(iii) _____________________

______________

_____________________

(iv) _____________________

______________

_____________________

(v) _____________________

______________

_____________________

Note: Copies of academic certificates and testimonials must be attached.

Date: …………………………………

Signature of Applicant …………………………