KENYATTA UNIVERSITY


KENYATTA UNIVERSITY

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 KENYATTA UNIVERSITY


helb application form for continuing students - FINANCIAL AID OFFICE

Tel: 0725-847914                                 P.O. Box 43844, 00100
         8710901 Ext. 57522 or (020)8704535
                                    NAIROBI, KENYA
                                    E-mail: financial-aid@ku.ac.ke

APPLICATION FORM FOR OVS CONTINUING STUDENTS 2015/2016 ACADEMIC YEAR
- www.helb.co.ke loan application form
This form must be completed before one can be considered for financial assistance. Students MUST:
1.    Be enrolled into a full time degree programme at Kenyatta University.
2.    Have a genuine need for Financial Assistance.
3.    Be a full time student during any Semester in which assistance is received.
4.    Must have National ID

Print in ink or type all answers clearly and completely. Indicate N/A if a question is not applicable.

Disclaimer
Any student or person filling this Application form and knowingly gives false or misleading information whether in writing or by attaching herein the false document (s) shall lead to automatic disqualification.

PART A: STUDENT PERSONAL DETAILS
a.    Name: ____________________        ______________________        __________________
        Last                First                Middle

b.    KU Student Adm. No. _____________  Degree (e.g. B A): ___________    Year of Study: _______

c.    Indicate your two semester sessions:    Semester 1    Semester 2    Semester 3
                    Sept to Dec    Jan to April    May to July

d.    Number of semesters remaining to complete degree: _______________

e.    Number of semesters called off: (Attach evidence) ____________

f.    Gender:    Male:         Female:    
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g.    Date of Birth: ____________________   

h.     ID NO. _________________________ (attach copy)

i.    Special needs:
Visually Challenged         Physically Challenged        Other (specify)     _____________

j.    University Academic performance: Average Grade ______________( attach KU result slip)

k.    Address: P.O. Box: _______________________________________

l.     County: _______________________
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m.    Mobile  Number: _______________   

n.    Alternate Mobile No. ___________________________

o.    E-mail address: ___________________________

PART B: PARENTS DETAILS
Indicate if you are from: Single Parent         Both Parents

2. FATHER     1.    3. MOTHER
a)    Is your Father alive? Yes             No.     a)    Is your Mother alive? Yes             No.
b)    If no, give date of death;__________________
(Attach Death Certificate)    b)…..If no, give date of death;___________________
(Attach Death Certificate)
c)    If yes in (a) above, please fill below    c) If yes in (a) above, please fill below
d)    If yes give his age; ________________    d) If yes give her age; ________________
e)    Name: ______________________ ID/No. _________    e) Name: ______________________ ID/No. _________
f)    Occupation: _________________________________   
f)    Occupation;_________________________________
g)    Name and address of employer (s)   
g)    Name and address of employer (s)
h)    If retired give name (s) and address of last employer (s);
          ___________________________________________
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        Year of retirement: __________________________
    h)    If retired give name (s) and address of last employer (s); __________________________________________

                Year of retirement: ________________________

4. GUARDIAN/SPONSOR/NEXT OF KIN
a)    Name: _________________________________________b) Mobile Telephone : _______________________

c)    ID/ No: ______________________________________ d) Occupation: _______________________________
- helb application form for continuing students 2015/16
e)    Name and address of employer:______________________________________________________________
PART C: INFORMATION ABOUT FINANCIAL STATUS
NOTE: Financial Aid at Kenyatta University is limited due to the large number of students applying for assistance and is therefore only awarded to students who are in genuine financial difficulties.
1.    (a) Gross family income in the last 12 months
ITEM    FATHER    MOTHER    GUARDIAN/
SPONSOR    TOTAL
Gross income from employment (Salary or Pension)               
Income from Business e.g. Shop, Hotel, Matatu.               
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Income from farming e.g. Crops, Livestock, Fishing.                
Income from other sources e.g. Shares, Dividends, Interest               
Income from Harambee and Donations.               

Others e.g.CDF, HELB, NGO
               
TOTAL
               

(b)    Applicant’s Siblings in Educational Institution (Please include documentary evidence)
CHILD’S NAME    INSTITUTION NAME    YEAR OF STUDY    EXPECTED EDUCATION EXPENDITURES
1.           
2.           
3.           
4.           
5.           
6.           
TOTAL           
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(c)    Number and age of siblings not in school _________________
PART D: ADDITIONAL INFORMATION

(a)    Indicate the Financial Aid you have received from KU
SN    SOURCE    YES/NO    HOW MANY TIMES APPLIED    HOW MANY TIMES RECEIVED
1    KU Internal Bursary           
2    SomeshaMwenzako Bursary           
3    OVS Scholarship           

(b) APart from the Financial Assistance you are applying for at Kenyatta University have you applied for any other scholarship(s)        Yes:        No:
If yes, please specify;
1.    _________________________________________________________________________________________
2.    _________________________________________________________________________________________
3.    - www.helb.ac.ke application forms
_________________________________________________________________________________________
CERTIFICATION
I hereby certify that all the information I have provided on this form and all supplementary forms is true, correct, and complete. I hereby authorize Kenyatta University or its representatives to obtain such additional information concerning my educational programme and financial records needed to complete processing of this application. It is also my understanding that Kenyatta University, may, as it seems appropriate, release to others who may be considering me for financial assistance or making decisions relating to my educational plans, information concerning the amount of any award I may receive.

Applicant signature: _________________________    Date: ________________________

Note: The filling of an application form for Financial Aid from Kenyatta University, does not guarantee that the applicant will receive Aid.

FOR OFFICIAL USE ONLY
Date Received _______________________Receiving officer _______________________ Signature ______________



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