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    CDF Bursary Form-Colleges & University - Rarieda

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    huduma kisumu
    1) This document is a bursary application form for students joining public universities or colleges in Rarieda constituency. 2) It requests personal details of the student and family, including parents' occupations and income, as well as school fees balance and siblings in school. 3) A chief or religious leader must recommend the applicant and confirm the information provided before the bursary committee determines if the student will be awarded a bursary.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    CDF Bursary Form-Colleges & University - Rarieda

    Uploaded by

    huduma kisumu
    238 views4 pages
    1) This document is a bursary application form for students joining public universities or colleges in Rarieda constituency. 2) It requests personal details of the student and family, including parents' occupations and income, as well as school fees balance and siblings in school. 3) A chief or religious leader must recommend the applicant and confirm the information provided before the bursary committee determines if the student will be awarded a bursary.

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    Cdf Bursary Form-colleges & University - Rarieda

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    1) This document is a bursary application form for students joining public universities or colleges in Rarieda constituency. 2) It requests personal details of the student and family, including parents' occupations and income, as well as school fees balance and siblings in school. 3) A chief or religious leader must recommend the applicant and confirm the information provided before the bursary committee determines if the student will be awarded a bursary.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    238 views4 pages

    CDF Bursary Form-Colleges & University - Rarieda

    Uploaded by

    huduma kisumu
    1) This document is a bursary application form for students joining public universities or colleges in Rarieda constituency. 2) It requests personal details of the student and family, including parents' occupations and income, as well as school fees balance and siblings in school. 3) A chief or religious leader must recommend the applicant and confirm the information provided before the bursary committee determines if the student will be awarded a bursary.

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    © All Rights Reserved
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    NATIONAL GOVERNMENT CONSTITUENCIES DEVELOPMENT FUND

    RARIEDA CONSTITUENCY

    Serial No.
    Bursary Application Form

    College and University

    NAME OF STUDENT DATE RETURNED


    ………………………………………………. ………………………………………..
    ……………………………………………….. ……………………………………………………….
    GUIDELINES FOR THE APPLICANTS
    1. This application form is issued FREE of charge by RARIEDA NGCDF OFFICE. It is meant for students IN/JOINING. (1) public universities (in the
    regular and parallel programmes and (2) other post-secondary public colleges) e.g. colleges of science and technology as well as teachers’ training
    colleges.
    2. All applicants must provide the details required. Incomplete loan forms will not be processed, for example, where documentary evidence is required
    but not provided. The information provided must be correct and any student or person filling this loan form who knowingly makes false statements
    orally or in writing is liable of prosecution
    3. Please note that all information provided will be cross – checked (by the NGCDF Secretariat) with other information from the relevant official/ public
    sources: The NGCDF office will ensure that only deserving cases will be assisted.

    Fill in the required information in the spaces provided.

    Total Fees (Annual): ________________ Paid/Able to raise: _____________ Balance______________

    FOR OFFICIAL USE ONLY: Received by ________________ Serial No.______________________


    Signature ___________________ Date____________________________

    PART A: PERSONAL DETAILS OF STUDENT


    1. Name of the Student: __________________________________________Reg./Adm No._________________________
    2. ID NO. (Where applicable) _____________________________________________________
    3. Permanent Home Address ____________________________________________________________
    4. Sex: A. Male B. Female 5. Marital Status: A. Married B. Single
    5. Date of Birth (DD/MM/YY: __________________________
    6. Place of birth (or Residence)
    DISTRICT ________________________________ DIVISION _________________________________
    WARD ___________________________________ LOCATION _______________________________
    SUB – LOCATION __________________________ VILLAGE /ESTATE /UNIT ___________________
    PARENT / GUARDIAN ____________________________________________________
    ID No.________________________ VOTERS CARDS (Students /Parent/Guardian) ______________
    Contact: (Mobile) Self/ Parent’s/Guardian’s______________________________________________

    1 RARIEDA NG-CDF | BURSARY APPLICATION FORM | COLLEGE AND UNIVERSITY


    PART B: PERSONAL DETAILS OF THE FATHER/MOTHER/GUARDIAN
    This section should also apply for applicants who are under the care of a guardian.

    7. Are both your parents alive? 1. Yes. ____2. No ____ [f one or both parents are deceased, attach death certificate(s)].

    8. Who takes care of your school fees? A. Father B. Mother B. Guardian


    9. Name of the Father/ Guardian: __________________________________Occupation: _____________________________
    10. Name of the Mother: _________________________________________ Occupation: _______________________________
    11. Permanent Address of the Parents/Guardian: ______________________________________________________________

    PART C: FAMILY TYPES AND SIZE


    12. Describe the type of your family: (1) Parents living together (2) Parents have separated (3) Parents

    have divorced (4) I am a child of a single parent (5) other (specify) __________________________________
    13. How big is your family? 1. Number of brothers _______ 2. Number of sisters __________

    PART D: INFORMATION ABOUT YOUR SCHOOL/ COLLEGE /UNIVERSITY


    14. Name of your College/University: ____________________________________________________________________
    15. Full address of the School/ college: _________________________________ Tel._____________________________
    16. Current class/year of study: __________________________ (Attach your result slip/ report form or any other document to
    confirm your student status).
    17. Total fees for the year: Kshs ______________________ (Attach a fee statement showing the total fee due for the year).
    18. Total outstanding (current) fees balance: Kshs ____________________ (Attached supporting statement from the
    school duly signed and stamped by the school authority (Registrar/ Bursar).
    19. Have you ever applied for bursary before? Yes …….. No ………. (Tick one)
    20. Have you ever benefited before? Yes …….. No ………. (Tick one)
    If Yes, (in 20 above) indicate the year and amount allocated. Year ………………. Amount …………
    Year ……………..Amount ………… Year ………. Amount ………… Year ………. Amount …………

    PART E. APPLICANTS SIBLINGS IN SCHOOL / INSTITUTION.

    Names Relationship School / Year or Total Fees Outstanding


    Institution Class Balance

    GRAND TOTAL

    2 RARIEDA NG-CDF | BURSARY APPLICATION FORM | COLLEGE AND UNIVERSITY


    PART F: INFORMATION ABOUT FAMILY FINANCIAL STATUS.

    1. GROSS INCOME IN THE LAST 12 MONTHS (KSHS)


    Gross Income (this means income from salary, business or farming)

    Father Mother Husband Wife Guardian / Sponsor


    GROSS INCOME

    PART G: RECOMMENDATION:

    a) Area Chief / Assistant Chief/Religious Leader - Comment on the student /family/ parent status.
    -----------------------------------------------------------------------------------------------------------
    ---------------------------------------------------------------------------------------------------
    ---------------------------------------------------------------------------------------------------
    --------------------------------------------------------------------------------------------------
    Assessment of the applicant: 1. Very needy 2. Needy 3. Not Needy

    I declare that I know the contents of this application form and hereby confirm that the information herein is true to
    the best of my knowledge
    __________________________ _______________ _________________
    Name Signature Date & Official Stamp.

    PART H: DECLARATIONS

    1. Applicant’s declaration: I declare that the information given herein is true to the best of my
    knowledge and I am willing and available to verify it if need be.

    Applicant’s full Name: ________________________________________________________________


    Adm. / Reg. No: _____________________ ________ID No.:__________________________________
    Date: ______________________________________Signature__________________________________________________

    2. Parent / Guardian Declaration I declare that I have read this form/ this form has been read to me and I
    hereby confirm that the information given is true to the best of my knowledge.

    __________________________ _______________ _________________


    Name (Parent /Guardian) Signature Date.

    3 RARIEDA NG-CDF | BURSARY APPLICATION FORM | COLLEGE AND UNIVERSITY


    PART I: FOR OFFICIAL USE BY THE BURSARY COMMITTEE
    Recommended /Not Recommended for Bursary

    Comments: ___________________________________________________________________________________________
    ___________________________________________________________________________________________

    ___________________________________________________________________________________________

    Bursary award: Kshs. ______________________________ Score

    Officials
    Name Designation Signature
    1.

    2.

    3.

    4.

    4 RARIEDA NG-CDF | BURSARY APPLICATION FORM | COLLEGE AND UNIVERSITY

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