SOTTUC WELFARE COMMITTEE BURSARY FORM. SOTTUC

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SOTTUC WELFARE COMMITTEE BURSARY FORM.
A. PERSONAL DETAILS
1. NAME…………………………………………………………………Reg No……………………………………………………….
2. Department……………………………………………………..Course………………………………………………………….
3. Year of Study……………………………………………………Programme(JAB/SSP)…………………………
4. National ID NO……………………………………………(attach a copy of the ID)
5. E-mail Address……………………………………………...
B. FAMILY DETAILS:
1. Father’s Name……………………………………………………..Occupation…………………………………….
2. Mother’s Name………………………………………………….Occupation…………………………………….
3. Guardian’s Name………………………………………………….Occupation………………………………….
4. If both or one of the parents is not there, state reason e.g. Separation, Divorce, and
Death………………
NB:
i.
Attach copy of no. 1 and no. 2 or no. 3 where applicable
ii.
Attach supporting document for no. 4
5. Siblings in High School:
NAME
SCHOOL/LEVEL/CLASS
FEES PAYABLE
C. FEES PAYMENT DETAILS:
1. Total Fees payable………………………………..
2. Amount Paid/Able to raise: …………………….
3. Outstanding Balance……………………………….
4. Who pays your School Fees? (Parent/Guardian/Sponsor)…………………………..
5. Do you receive HELB Loan? ................If yes, state amount………………………..
6. Have you received Bursary from any fund? ..............
 Amount from CDF: …………………………..
 Amount from HELB: ………………………….
 Other (Specify): ………………………………….
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SOTTUC-SWEC P.O BOX 635-80300, VOI KENYA Page 1
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D. CLARIFICATION:
Give reasons why you should be awarded Bursary/ why you consider yourself needy:
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E. APPLICANT’S DECLARATION:
I declare that the information given herein is true to the best of my knowledge.
Signature:………………………………………………….Date:…………………………………………
F. OFFICIAL USE ONLY:
1. Verification by Finance Officer:
Student’s Balance:………………………………..
Signature:……………………………………Date:…………………………….
2. Verification by the Dean of Students:
Signature:………………………………………Date:……………….
3. Welfare Committee:
AMOUNT AWARDED:……………………………………………
Committee Chairperson:……………………………..Date:…………………….
Committee Secretary:…………………………………Date:……………………….
NB: The committee will disqualify any applicant who will submit incorrect, false or misleading
information.
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