APPLICATION FOR SCHOLARSHIP

RIDGEWAYS BAPTIST CHURCH

Name as per result slip:		Date of birth:
Primary school attended		NEMISIS NO:
Secondary school admitted to:		Contact person Name:
Contact person relationship:		Telephone:
County of Residence	Select County Baringo Bomet Bungoma Busia Elgeyo Marakwet Embu Garissa Homa Bay Isiolo Kajiado Kakamega Kericho Kiambu Kilifi Kirinyaga Kisii Kisumu Kitui Kwale Laikipia Lamu Machakos Makueni Mandera Marsabit Meru Migori Mombasa Murang'a Nairobi City Nakuru Nandi Narok Nyamira Nyandarua Nyeri Samburu Siaya Taita Taveta Tana River Tharaka Nithi Trans Nzoia Turkana Uasin Gishu Vihiga Wajir West Pokot	Gender	Select Gender Female Male
Sub_county:		Ward:

Question	Father	Mother	Guardian
Tick if they are alive?
Name of
If deceased, please attach copy of death/burial certificate
Religion/Church/Faith
Am Living With
Is Employed?
Works as Casual Labourer in
Owns a Business?
Owns a Piece of Land?
Has Other Income From
Earns on an Average Per Month

Please list all your Brothers and sisters starting with the oldest, stating education attained and what each is doing

Name	Age	Education Level	Occupation	Action
				Add Row

Attach your Results slip	Attach your Leaving certificate
Attach highschool Calling Letter	Attach recommendation Letter from religious Leader
Attach your recommendation Letter from chief

Submit Application