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O. Box 43844 00100 GPO NAIROBI. Tel 8710901-19 Cisco 020 8703061 or 020 8703210 Email registrar. acd ku. ac.ke 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 National Identity Card copy. KENYATTA UNIVERSITY Serial No. OFFICE OF THE REGISTRAR ACADEMIC APPLICATION FOR ADMISSION INTO KENYATTA UNIVERSITY UNDERGRADUATE PROGRAMMES NOTES i This form should be typed...or completed in BLOCK LETTERS and returned to The Registrar Academic Kenyatta University P. O. Box 43844 00100 GPO NAIROBI. Tel 8710901-19 Cisco 020 8703061 or 020 8703210 Email registrar. acd ku. O. Box 43844 00100 GPO NAIROBI. Tel 8710901-19 Cisco 020 8703061 or 020 8703210 Email registrar. acd ku. ac*ke 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...National Identity Card copy. iii Applicants from East Africa to pay a sum of Kshs. 2 000/- and those from outside East Africa pay Kshs. 4 000/- as application fee through the Bank Account provided in the advertisement. iv Attach Two one by one inch 1 x 1 photographs Passport size. SECTION A 1 Name. Surname Other names in full 2 Contact Address. 3 Permanent Address. Telephone No Mobile No. Email. Nearest Town. 4 Date of Birth Day Month. Year. 5 Nationality. 6 Identity Card No ...Passport No* 7 Gender Male Female 8 Do you have any form of physical disability Marital Status. Yes No If so indicate the form of disability Page 1 of 4 a Name of Degree/Diploma/Certificate applied b i. Mode of study Tick as appropriate Full Time Preferred Campus To be ticked by Full time applicants only Nyeri Campus Parklands Campus City Campus Ruiru Campus Nakuru Campus Kitui Campus Mombasa Campus Kericho Campus K. I. S*T. Centre Embu Campus ii. Main...Campus K. U. Others Specify. Part Time Evening and Weekends Institution - Based To be ticked by Institution -Based applicants only Offered in the Months of April August December iv* Open Learning Digital School Preferred Centre To be ticked by Digital School applicants only Nairobi Embu Nakuru Nyeri Kisumu Mombasa Kakamega Garissa Marsabit Kericho 10. Institutions attended and Qualifications obtained starting with the latest. YEAR OF QUALIFICATIONS SCHOOL/COLLEGE/UNIVERSITY ATTENDED GRADES...COMPLETION OBTAINED/CLASSIFICATION i Academic high school Certificates ii Professional courses 11. Work/Research experience where applicable OCCUPATION EMPLOYER WORK STATION DECLARATION BY THE APPLICANT I hereby declare that to the best of my knowledge that the information I have provided is correct. Signature Date DURATION For Official Use Only Recommendations Approved Deferred Reasons for deferment Incomplete Information Others Date. ac*ke 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 National Identity Card copy. iii Applicants from East Africa to pay a sum of Kshs. 2 000/- and those from outside East Africa pay Kshs.