Serial No
KENYATTA UNIVERSITY OFFICE OF THE REGISTRAR (ACADEMIC) INTERNATIONAL STUDENT APPLICATION FORM FOR ADMISSION INTO KENYATTA UNIVERSITY UNDERGRADUATE AND POSTGRADUATE PROGRAMMES
NOTES: (i) This form should be typed or completed in BLOCK LETTERS, and returned to the Registrar (Academic), Kenyatta University THROUGH:
The Director, Center for International Programmes and Collaboration (CIPC), Kenyatta University, P.O. Box 43844 - 00100 GPO, Tel: +254 701 377 549/ +254 734 029 106 NAIROBI-KENYA (ii) Attach Copies of: (a) Your current appointment letter (where applicable), (b) Your professional and academic certificates and transcripts, (c) Original receipt of payment for application form (d) Passport
(iii)Undergraduate applicants from East Africa to pay a sum of KShs. 2,000/- as application fee while those from outside East Africa to pay USD 50. Payments to be made to the following bank account:
(iv) Postgraduate applicants from East Africa to pay a sum of KShs. 3,000/- and those from outside East Africa pay USD 50. as application fee through the Bank Account provided in the advertisement.
Bank Bank Account Name Branch Ac. No. Swift Code Name Code
National 12026 Kenyatta University Kenyatta 02020059150800 NBKEKENXXXX Bank of Tuition Account University Kenya
(v) Attach four one inch by one inch (1” x 1”) passport-size photographs.
(vi) Application deadlines are end of May for September intake and end of September for January intake.
SECTION A
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1) Name……………………..…………… ……………..……………………………..……… (Surname) (Other names in full) 2) Contact Address ..……………….………………………………………………………...... ……………………………………………………………………………………………..…… 3) Permanent Address ………………….………….……………………………………..………. ………………………………………………………………………………………….………. .………………………………….…………………………………………………………….. Telephone No ……………………………… Mobile No …………….……….……….…...
E-mail ...…………….…………………………………………………......
Nearest town……………………..……………………………………………………….…...
3b) Contacts of next of kin in case of emergency i.)Name………………………………………………….. Relationship………………………………….
Telephone No: ……………………………… ……………Mobile No: ………………………………. i.i) Name…………………………………………………….Relationship……………………………….
Telephone No: ……………………………… ……………..Mobile No…………….………………….
3c.)Contacts of sponsor(s) where applicable i.) Sponsor’s name ………………………………………………………………………………………..
Telephone No: ……………………………… ……………..Mobile No…………….………………..
ii.)Sponsor’s name ………………………………………………………………………………………..
Telephone No: ……………………………… ……………..Mobile No…………….…………………….
4) Date of Birth:
Day………………………. Month …….……………………….Year………………….…..
5) Citizenship …………………………..…………………………………………………….….
6) Passport No.…………………….…. Identity Card No…………………………….…………
7) Gender: Male ……………..… Female ……..…..…… Marital Status …..…………..……
8).Do you have any form of physical disability? Yes No
If so please indicate the specific nature of disability………………………………………………
NB: Kindly note that the information on the nature of disability will not be used against the student Page 2 of 6
8) How did you learn about Kenyatta University programmes? Please tick as appropriate
Newspapers
Television/Radio
Kenyatta University Website
Social media
Career Fair
11 Others (Please specify)…………………………………………….
9) Previous enrolment information
a) Have you previously applied for a programme at Kenyatta University? If yes please indicate programme and registration number
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
SECTION B
8) (a) Name of Degree/Diploma/Certificate applied for:
..………………………………………………………………………………………….....
(b) Mode of study (Tick as appropriate)
i. Full Time: Preferred Campus (To be ticked by Full time applicants only)
Main Campus Nyeri Campus
Parklands City Campus
Ruiru Campus Nakuru Campus
Kitui Campus Mombasa Campus
Kericho Centre Others (specify)
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ii. Evening and Weekends/ Part Time
Parklands Nakuru Campus
City Campus Others (Specify)
iii. Institution Based: (To be ticked by Institution based applicants only)
Main Campus (K.U.) Mombasa Campus
Kericho Centre Others (Specify)
Nakuru Campus
iv. Open Learning (ODeL): Preferred Centre (To be ticked by IOL applicants only)
Nairobi Embu
Nakuru Nyeri
Kisumu Mombasa
Kakamega Garissa
Others (Specify)
9. English Proficiency
Are you proficient in English? Yes No
If yes, please provide evidence
Do you need help to improve your English Proficiency? Yes No
10. Institution attended and Qualifications obtained.
QUALIFICATIONS SCHOOL/COLLEGE/UNIVERSITY YEAR OF GRADES ATTENDED COMPLETION OBTAINED (i) Academic
(ii) Professional
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10. Work/Research experience (where applicable)
OCCUPATION EMPLOYER WORK STATION DURATION
SECTION C
DECLARATION BY APPLICANT
I hereby declare that to the best of my knowledge, the information I have given is correct.
Signature ……………………….…………………Date ….…………….……………………….
SECTION D
For Official Use Only:
Recommendations …………………………………………………………………………………
……………………………………………………………………………………………………...
……………………………………………………………………………………………………...
Approved
Not Approved
Deferred
Reasons: Incomplete Information
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Others:………………………………………………………………………………
Signature: ……………………………Date:………………………………
SECTION E
12. Action to be taken Admit
Reject
Follow- up action: …………………………………………………………………………..
…………………………………………………………...……………………………………
Signature :………………………………………. Date :………………………………
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