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First Name:
Middle Name:
Surname:
Date of Birth:

Age:
Gender:
Home Address:
Town: Constituency: County:
Postal Code:
Phone Number:
Email Address:

Home Address:
Town: Constituency: County:
Postal Code:
Phone Number:
Email Address:

Highest Education Level Completed:
Name of Last Secondary School Attended:
Year of Completion:
KCSE Index No.:

Desired Program: Full-Time Part-Time

Preferred Mode of Learning: On-Campus Online Hybrid

Application Fee: Ksh.2000
MPESA Paybill: 516600
Account Number: 0997605001

Payment Method: Bank Deposit MPESA Paybill

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