Online Application Form
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Basic Information
Full Name
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First Name
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Year
Course/Programme Applying for:
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PhD in Community Health and Development
PhD in Business Administration
PhD in Agribusiness Management
Master of Community Health and Development (MCHD)
Master of Science (MSc.) in Nursing
Master of Public Health (MPH) in Nursing
Master of Science (MSc.) in Community Nutrition
Master of Theology (M.Th.)
Master of Business Administration (MBA)
Master of Science (MSc.) in Agribusiness Management
Bachelor of Science in Nursing
Bachelor of Science (BSc.) in Community Health & Development
Bachelor of Science (BSc.) in Community Nutrition
Bachelor of Science (BSc.) in Clinical Medicine & Community Health
Bachelor of Science (BSc.) in Physiotherapy & Rehabilitation Medicine
Bachelor of Education (B.Ed. Arts)
Bachelor of Arts in Counseling Psychology
Bachelor of Theology
Bachelor of Arts in Business Administration
Bachelor of Science in Information Technology
Bachelor of Science in Agribusiness Management
Bachelor of Science in Hospitality & Tourism
Diploma in Community Health & Development
Diploma in Community Nutrition
Diploma in Hospitality & Tourism
Diploma in Information Technology
Diploma in Agribusiness Management
Diploma in Clinical Medicine & Community Health
Diploma in Education (ECD)
Diploma in Education (PRIMARY EDUCATION)
Diploma in Education (SECONDARY EDUCATION)
Diploma in Business Administration
Diploma in Food & Beverage Production, Sales & Service Management (KNEC)
Diploma in Catering & Accommodation (KNEC)
Diploma in House Keeping & Laundry (KNEC)
Diploma in Tourism Management (KNEC)
Diploma in Tour Guiding & Operations Management (KNEC)
Diploma in Sales & Marketing (Module i, ii, iii,) (KNEC)
Diploma in Human Resource Management (Module i, ii, iii,) (KNEC)
Diploma in Accountancy (KNEC)
Diploma in Co-operative Management (KNEC)
Diploma in Supply Chain Management (KNEC)
Diploma in Entrepreneurship Development (KNEC)
Certified Public Accountants (CPA) (KASNEB)
Accounting Technician Diploma (ATD) (KASNEB)
Certificate in Community Health and Development(For Community Health Personnel)
Certificate in Community Nutrition
Certificate in Counseling Psychology
Certificate in Theology
Certificate in Business Administration
Certificate in Information Technology
Certificate in Agribusiness Management
Certificate in Tourism and Hospitality
Certificate in Food & Beverage Production, Sales & Service Management (KNEC)
Certificate in Catering & Accommodation (KNEC)
Certificate in House Keeping & Laundry (KNEC)
Certificate in Tour Guiding & Operations Management (KNEC)
Certificate In Project Management (KNEC)
Certificate in Information Studies (Module I & II) (KNEC)
Certificate in Business Management (Module I & II) (KNEC)
Certificate in Supply Chain Management (Module I & II) (KNEC)
Certificate in Human Resource Management (Module I & II) (KNEC)
HIV/AIDS Testing & Counseling (NASCOP)
for Incoming A.Y. '12-'13
Mode of Study
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Full-Time
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Ministry Based
KUCCPS
E-mail
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ex: webmaster@gluk.ac.ke
Phone Number 1
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Phone Number 2
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Student Index Number/National ID
e.g. 11183021
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Taita Taveta County
Tana River County
Tharaka Nithi County
Trans Nzoia County
Turkana County
Uasin Gishu County
Vihiga County
Wajir County
West Pokot County
for Incoming A.Y. '12-'13
Marital Status
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Present Address
Street Address
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Person to contact in case of emergency:
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Parent/Guardian - (Phone Number)
Relationship
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ex. Father, Mother, etc.
Academic Background
High School Name
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Mean Grade
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Academic Certs
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Mathematics
English
Kiswahili
Physics
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Biology
Geography
History
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CRE/IRE
Business
Other Subject (please indicate the subject with the grade)
Extra Curricular Participation
Student Council
Class Officer
Club/Organization
Varsity Player
Others (please specify below)
Bank Slip Attachment
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Other Details
Skills/Talents
Acting
Arts/Crafts
Calculating
Dancing
Debating
Drawing
Eating
Fashion
Photography
Playing drums
Playing guitar
Playing piano
Programming
Singing
Writing
Others (specify below)
Other Skills/talents
Sports
Badminton
Basketball
Bowling
Chess
Frisbee
Scrabble
Soccer
Softball
Swimming
Table Tennis
Track and Field
Tennis
Volleyball
Others (specify below)
Other Sports
How did you hear about us?
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Do you have any scholarship?
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If Yes, who/what is the name of your sponsor?
Do you plan to shift to another course?
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If Yes, to what course?
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