Scribd
Upload
53 views4 pages

Application Form New 2023 F

Uploaded by

omaa65563
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
53 views4 pages

Application Form New 2023 F

Uploaded by

omaa65563
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 4

Page |1

JFC MUNENE COLLEGE OF HEALTH SCIENCES


P.O Box 1786-01000 Thika, Kenya
Tel: 0700 114 115 / 0703 114 115 Email: admissions@jfccollege.ac.ke
Website: www.jfccollege.ac.ke

APPLICATION FORM

STUDENT DATA AND INFORMATION


Note 1. To be completed in BLOCK LETTERS
Course Applied for: Option 1.

Option 2.

First Name: Middle Name: Surname:

Permanent Address:

Mobile Phone: Alternative Phone:

E-mail:

Skype ID: LinkedIn ID:

BIRTH DETAILS

Date of Birth: DD/MM/YYYY Blood Group: Country:

Division: DD/MM/YYYY Location: Home Town:

Place of Birth: Country:

NATIONALITY DETAILS
Primary Citizenship: Secondary Citizenship:

Current Passport No: Current ID No:

Religion:

Gender: Male Female Intersex Mr Ms Mrs

JFC MUNENECOLLEGE OF HEALTH SCINCES -2024/25 P a g e 1|4


Page |2

MOBILITY LICENSES

Driving License: Disability License:

SOCIAL MEDIA - Please provide your ID for:


LinkedIn: Facebook:
Twitter: Instagram:
Telegram: Any Other:

MARITAL STATUS

Single: Married: Divorced: Separated:

IMMEDIATE FAMILY DETAILS

Member Name Age Occupation Dependent Passport/ID


or not Number
Father
Email.
Mother
Email.
Guardian
Email

EDUCATION QUALIFICATIONS

Category Name of Institution Level (e.g Course Year of Marks/


diploma, degree) Passing Grade
Primary
KCPE
Secondary
KCSE

College 1

College 2

University 1

Preferred January March May July September November


Intake
JFC MUNENECOLLEGE OF HEALTH SCINCES -2024/25 P a g e 2|4
Page |3

COMPUTER PROFICIENCY

Tick your level of proficiency in computer packages


Basic: Good: Very Good: Excellent:

WORK EXPERIENCE (In service students)

Current Work Experience


Name of Organization:
Address: Type of Business:
Brief Job description:
…………………………………………………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………………………………………………
…………………………………………………………………………………………

Reasons for seeking Studies


…………………………………………………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………………………………………………
…………………………………………………………………………………………
MISCELLANEOUS

Currently Employed: Yes No

MEDICAL HISTORY

i. Do you suffer from diabetes/blood sugar? YES ….. NO …..


ii. Do you suffer from blood pressure? YES ….. NO …..
iii. Do you suffer from cholesterol? YES ….. NO …..
iv. Do you have any other health issues? YES ….. NO …..

JFC MUNENECOLLEGE OF HEALTH SCINCES -2024/25 P a g e 3|4


Page |4

DECLARATION

I, ………………………………………………………………………………. solemnly declare and affirm that the above


information submitted is true to the best of my knowledge, and hereby give my permission to the
admissions office to obtain any verification deemed necessary to process my application certify that I will
arrange for the forwarding of official transcripts as requested in the instructions, and that transcripts
become the property of JFC Munene College and will neither be forwarded to another institution nor
returned to me. I will include with this application fee receipt and other documents as required in the
application process.

Date: Signature:

……………………………………………… ……………………………………………………………
Note 2. Only complete applications will be processed. Deadlines must be observed.

FOR OFFICIAL USE ONLY

Application No:
Application Fees receipt no. Date:
Application transaction code: Date:

Admission committee officer:


Signature:

Registrar Office:
Registrar’s Comments:…………………………………………………………………………………………………………………………

Note 3. JFC MUNENE COLLEGE OF HEALTH SCIENCES RESERVES THE RIGHT OF ADMISSION.

More information may be obtained from the office of Registrar.

www.jfccollege.ac.ke

JFC MUNENECOLLEGE OF HEALTH SCINCES -2024/25 P a g e 4|4

You might also like

pFad - Phonifier reborn

Pfad - The Proxy pFad of © 2024 Garber Painting. All rights reserved.

Note: This service is not intended for secure transactions such as banking, social media, email, or purchasing. Use at your own risk. We assume no liability whatsoever for broken pages.


Alternative Proxies:

Alternative Proxy

pFad Proxy

pFad v3 Proxy

pFad v4 Proxy