Chuka University Application Form – Fill Out and Use This PDF

APPLICATION FORM FOR SELF-SPONSORED UNDERGRADUATE DEGREE_____DIPLOMA____ AND

CERTIFICATE____ PROGRAMMES (tick as appropriate)

NOTES:

a)This form should be completed and returned to the REGISTRAR (ACADEMIC AFFAIRS), CHUKA UNIVERSITY COLLEGE, P.O. BOX 109 -60400, CHUKA, on or before the closing date as advertised.

b)Sections A, B, C and D of this form should be completed in Block Letters.

Ensure that you attach the Following;

c)Certified copies of your Result Slip, Certificates and Transcripts.

d)ORIGINAL RECEIPT (Application Fee): KShs. 2,000 for ALL Degree Programmes, Kshs. 2,000 for all

Undergraduate Diploma Programmes and Kshs. 1,000 for All Certificate Programmes: Payable to;

Account Name; Chuka University College, Kenya Commercial Bank; Account No: 1103755439 OR

Cooperative Bank; Account No: 0112905818900.

e)Copy of your National ID Card or Birth Certificate.

SECTION A: PERSONAL DATA

Name: ……………………………………………………………………………………………………………………………………….

(Surname)(Other names in full)

Date of Birth: ………………….Sex: ……………. Marital Status: …………………Religion: …….…………………..

c) State any relevant academic/professional qualifications or experience……………………………………………………

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SECTION C: CHOICE OF COURSES

State the course(s) for which you wish to be considered for admission.

State whether you are applying for Degree/Diploma/Certificate :_________________________________

Preferred Campus (Chuka, Embu Town, Igembe ):________________________

a)Have you ever been admitted to Chuka University College previously (YES/NO)? ____________________

If YES, indicate the previous Registration number………………………………………………………………………………………….

Give reasons for applying afresh …………………………………………………………………………………………………………………..

Indicate how you intend to finance your studies………………………………………………………………………………………….

SECTION D: DECLARATION