KCB FOUNDATION SCHOLARSHIP PROGRAMME

2023 APPLICATION FORM

Name of Applicant (As it appears on the birth certificate)

Name of Primary School Primary School Postal Address Primary School Email Address County of Primary School Index Number

KCPE Marks Gender

Dear Applicant,

We are excited that you are applying to KCB Foundation.

Before you begin filling out the application form, please read the information below carefully.

Qualification

Each applicant must be in the last year of primary school, registered to sit for their KCPE exams in 2022.
We accept applications from all 47 Refugee students who are duly registered are encouraged to apply.

Instructions

Please fill out the application form for 2022 ONLY, as clearly and completely as Where information is absolutely not available, please mark (NOT AVAILABLE). However, remember that the more information you make available to us, the better it is for us to evaluate your application. Forms from previous years WILL NOT be accepted.
Attach copies of the following documents, failure to which your application WILL NOT be considered;
1. Birth
2. Parent/Guardian
3. Parent Death Certificate, where
Evidence of Co-curricular activity
Evidence of
Payslip of Parent/Guardian if
High school calling letter

(i) KCPE results slip

Applicants to attend interviews with their application Forms and all documentation required, No application forms should be dropped of at any branch
All answers MUST be written in the spaces provided within the form and filled by the student applying for the position using his/her own handwriting and You are NOT allowed to insert any extra pages.
Only Complete Applications will be
Note that only shortlisted candidates will be
Any omission of the above will lead to automatic
We will verify all the information provided in this application

Important dates

Applicants to attend interviews with their application forms.

KCB Foundation interviews are held on Saturday 14th January 2023 across all counties, apart from Kisii and

Nyamira which will be held on Friday 13th January 2022.

For information on the Interview venues per county kindly visit any KCB Branch or the KCB Website.

SECTION TO BE FILLED BY STUDENT (MANDATORY)

APPLICANT’S PERSONAL DATA

First Name					Middle Name
Last Names
Date of Birth dd / mm / yyyy (Attach copy of Birth Certificate)					Gender Male	Female
Do you have any condition that requires special support?	YES	NO			If yes, please use the space below to give a brief explanation. Attach copies of medical certificates.
What religion are you?
Are you a citizen of Kenya?	YES	NO			If no, what country of citizenship? Where do you reside?
How did you find out about KCB Foundation Education Program?	Website		Radio	TV	Social Media	Information Session	Other
If other, please explain

SIBLING INFORMATION (BROTHERS AND SISTERS) MANDATORY

NAME	AGE	OCCUPATION	INCOME	INSTITUTION/SCHOOL	WHO PAYS

EXTRA-CURRICULAR ACTIVITIES

Please list below two outstanding activities that you have been involved in over the last two years and explain what you learnt from them. These could include entrepreneurial activities, sports, arts, clubs, student leadership, conferences, among others (Attach copies of certificates).
ACTIVITY	POSITION	NUMBER OF YEARS

SECTION TO BE FILLED BY PARENT/ GUARDIAN (MANDATORY)

PLEASE SELECT THE APPROPRIATE CHECKBOX SAMPLE

PARENT /GUARDIAN INFORMATION (MANDATORY)

Mother Alive YES NO Father Alive YES NO Guardian Alive YES NO	Mother Female Guardian	Father Female Guardian
	MOTHER OR FEMALE GUARDIAN INFORMATION	FATHER OR MALE GUARDIAN INFORMATION
First Name
Last Name
Married/divorced/separated/single parent/widowed (Describe as appropriate)
How are you related with your guardian? (If parent is deceased, attach death certificate or burial permit.)
Country of citizenship (If not Kenyan, state nationality)
Parent’s/ Guardian’s National ID number (Attach a copy)
Parent’s/ Guardian’s Name of employer
Do you own a business/self employed? If yes, describe and show the average monthly income by attaching either Bank statement/payslip/Mpesa statement
Income (Give details of salary per month and attach a copy of pay slip). Declare any other source of income
Permanent physical home address (Town, estate, nearest public landmark by name and exact location to the residence e.g. school, church, mosque, hospital).
Is house owned, rented or employer owned?
Who pays the Applicant’s School Fees?
To be signed by parent or legal guardian where parents are deceased. Any documents that can prove legal guardianship should be attached. Please sign below, accepting that you have read through this application in detail and can confirm the accuracy of the information provided.

MOTHER OR GUARDIAN 1
First Name	Last Name
Signature	Date of Birth dd / mm / yyyy
Telephone Number	Email
FATHER OR GUARDIAN 2
First Name	Last Name
Signature	Date of Birth dd / mm / yyyy
Telephone Number	Email

SECTION TO BE STRICTLY FILLED BY THE STUDENT (PLEASE WRITE ON THE SPACE PROVIDED)

What personal challenges have you gone through in your academic journey and how have you overcome

What is the most important thing you have learnt in life and how has it helped you? (Up to 150 words maximum)?

What would you like to do after graduating from college?

List any three strengths you have and examples of how you have demonstrated the said strengths in the last two years:

HEADTEACHER OR DEPUTY OF CURRENT SCHOOL

SECTION MUST BE SIGNED AND STAMPED USING THE OFFICIAL SCHOOL STAMP

To be filled only by the headteacher of school the applicant is currently attending

First Name					Last Name
Other Names
School Name
School Code Number
School Phone
School Email
Permanent physical address of School (State, town, estate, nearest public landmark to the school e.g church, mosque, hospital)
Email Address (School)
UPI Number (NEMIS)
School Type (Mark all School Type (Mark all that apply)
If other, please explain
Why would you recommend this applicant to the KCB Foundation ? Please comment on the applicants conduct, special interests, talent, and/or disability status (Use the space below for your response and sign and certify). Maximum 100 words.

How long has the student been in that School?

What extra curricula activities is the student involved in?

Comment on the family’s financial status

Comment on the student’s academic ability

Please sign below, accepting that you have read through this application in detail and can confirm the accuracy of the information provided.
Signature	Date dd / mm / yyyy

RECOMMENDATION BY EITHER DISTRICT EDUCATION OFFICER, CHIEF, PRIEST, PASTOR OR IMAM

First Name				Last Name
Other Names
Office Phone
Permanent physical address of School (State, town, estate, nearest public landmark to the school e.g church, mosque, hospital)
Postal Address
Email Address
Based on your knowledge and/or inquiries you have made, why would you recommend this applicant to KCB Foundation (Use the space below for your response and sign and certify)

Please sign below, accepting that you have read through this application in detail and can confirm the accuracy of the information provided.
Signature and Rubber Stamp	Date dd / mm / yyyy

STUDENT’S DISCLAIMER AND SIGNATURE

I certify that I have filled this form, that my answers are true and complete to the best of my knowledge. If this application leads to admission, I understand that false or misleading information in my application or interview will result in immediate disqualification from the application process and withdrawal of admission.
Signature (Student)	Date dd / mm / yyyy
Signature	Date dd / mm / yyyy

Declaration:

Applicant’s Declaration

I declare that the

information given above is true to the best of my knowledge. I authorise KCB Foundation to obtain such additional information concerning my educational program, family and financial records as needed to complete this scholarship application.

Applicant Name Signature Date

Parent/Guardian Declaration

I confirm that the

above information is true to the best of my knowledge and I am aware that giving false information will mean that the application will not be considered. On behalf of my child, I authorise KCB Foundation to obtain any additional information concerning this applicant’s education, family and financial records as needed to complete this scholarship application.

Applicant Name Signature Date

ABOUT US

KCB Foundation provides high school education scholarships for bright but marginalized and disadvantaged boys and girls, FGM Champions, Teenage mothers, girls rescued from early marriages, boys from regions highly affected by cattle rustling, and areas with high poverty indexes all from Kenya’s 47 counties through the provision of full scholarship opportunities that include tuition fees, learning materials, transport and shopping, and improved public schools infrastructure in order to improve access and transition to high-quality education. The Foundation also provides psychosocial support through mentorship opportunities in High school, Apprenticeship and University/Tertiary education levels.

Annually, the KCB Education Scholarship programme targets 1000 beneficiaries across all counties, with 100 of them being students with physical challenges who benefit from a full scholarship for four years of secondary education. The programme deliberately ensures inclusion by targeting 50% of women into the programme.

OUR IMPACT

3558 High school beneficiaries since 2007, effectively supporting transition to secondary education in public/government schools in
301 University/Tertiary beneficiaries since 2021, effectively supporting transition to tertiary/University education in Kenya
In the 2021 CSE, 91% of class scored the minimum University qualification of C+ with 34 learners scoring A’s, 129 scored B’s and 50 C+.
Transition rates from secondary school to tertiary education at 100 % from year to
Marked by a completion rate of 99% from year to

CONTACT US

KCB Head Office, Kencom House, 1st floor

P.O. Box 48400-00100 Nairobi

Mobile: (+254) 0711 012 729

Telephone: 020-3270000

E-mail: [email protected] Website: https://kcbgroup.com/foundation/ WhatsApp: 0711 087 087

2023 KCB Founadtion Scholarship Application Form Free