KTDA Form One Scholarship Application Form, Guidelines 2023

The KTDA National Tea Scholarship is a programme run by the KTDA Foundation to improve access to secondary education for bright and financially challenged students and to enhance the quality of education and lifelong learning.

KTDA Foundation has so far sponsored 1092 students through secondary school. To be eligible for consideration, the applicant must:

1. Be a Kenyan
2. Have sat for the Kenya Certificate of Primary Education (K.C.P.E) examination in 2022 in a public primary school that is recognized by the Ministry of Education in Kenya and obtained a minimum of 350 marks and above.
3. Be from a needy
4. Be from any of the 71 KTDA-managed tea factory catchment
5. Fill all the relevant sections and provide supporting evidence where applicable (e.g proof of income, death certificate etc.)

Interested students should fill and submit the KTDA Tea Scholarship Form and provide:

1. A certified copy of KCPE result
2. Relevant documentation as outlined in the application form (e.g filled application form, board resolution, birth certificate, KCPE result slip, recommendation letters from chief, pastor/former school principal, secondary school admission letter, death certificate where applicable)
3. Copy of birth
4. Copy of Form One admission letter (whereas the application form can be submitted without this, the candidate MUST

provide a copy of the Form One joining instructions as soon as available).

1. Evidence of being an orphan or vulnerable state where applicable

This application must be completely filled in and directions clearly followed. Incomplete forms or forms containing false in- formation will be rejected. Provide the required information in the space provided only.

Please fill this application and submit a hard copy to the Factory Unit Manager at the nearest KTDA-managed tea factory.

All parts of the form must be submitted to the Factory Unit Manager with supporting documentation not later than Friday 13th January 2023. Late applications will not be considered.

Name:

Surname: ………………………………………….. First Name: …………………………………… Middle Name: ……………………………………..

Date of Birth:

DD/MM/YYYY

Gender:     Male

Female

Postal Address:……………………………………………………………… E-mail: ……………………………………………………………………………

Physical Address: County: ……………………………………………………. Constituency: …………………………………………………………… Phone Number: ……………………………………………………..

 

KCPE Marks:                                                   Year:

Primary School: ……………………………………………………………………………………………………………………………………………………….

Postal Adress:  ………………………………………………………………………………………………………………………………………………………..

Headmaster/Headmistress Name: ……………………………………………………………………………………………………………………………..

Father’s / Guardian’s Name:

Surname: …………………………………… First Name: ……………………………….. Middle Name: ……………………………… Age: …………

Mother’s / Guardian’s Name:

Surname: ………………………………….. First Name: ……………………………….. Middle Name: ……………………………… Age: …………

Are your parents: Married:                                 Single:                                  Divorced:                                                                                 Widowed:

Mother Alive:  Yes:

No:

Father Alive: Yes:

No:

How Many Siblings (Brothers and Sisters) do you have?:                       Are you 1st, 2nd…Born:

How Many Siblings are still in school?: Primary:

Secondary:

University:

Other Tertiary Institutions:

Father’s / Guardian’s Highest level of education (write none if no education) ………………………………………………………………….

Mobile Number:                                                                     Email Address: ………………………………………………………………………..

Mother’s / Guardian’s Highest level of education (write none if no education) ………………………………………………………………….

Mobile Number:                                                                     Email Address: ………………………………………………………………………..

Additional Guardian: Name……………………………………………………………. Relationship: …………………………………………………….. Mobile Number:      Email Address: ………………………………………………………………………..

Parent’s/Guardian total annual income: Kshs Grower number

(where applicable)            Buying Centre: ……………………………………………

KTDA Factory: …………………………………………………………………………………………………………………………………………………………

Father’s / Mother’s / Guardian’s Occupation

Business person

Retired

Farmer

Professional

Unskilled

Total annual income: Kshs                                                         Other, Specify ……………………………………………………………………..

Name & Address of Father’s / Mother’s / Guardian’s Employer or Last Employer (if applicable)

………………………………………………………………………………………………………………………………………………………………………………

 

	Amount in Kshs.
Income per Month
Father’s/Guardian salary/ business
Mother’s/Guardian salary/ business
Tea earnings
Other sources (specify)
Total Income

 

 

Expenditure per month
Food, clothing etc
House rent
School fees for all children (Annually)
Loans
Medical
Others (specify)
Total Expenditure

 

What is your total need for which you are requesting assistance? Kshs Have you applied for financial assistance for your secondary education?

CDF Assistance?             Yes                   No

 

Other Scholarships?        Yes                   No

 

What is the status of your application?………………………………………………………………………………………………………………………..

If yes, please state which one(s) requested and amount:……………………………………………………………………………………………….

………………………………………………………………………………………………………………………………………………………………………………

State briefly why you should be considered for this scholarship

Applicant’s declaration:

I,…………………………………………………………………………………………. confirm that all the information provided is true and correct. I

accept responsibility for any information found to be false / misleading. I authorize KTDA Foundation to obtain any further information required to use and release information regarding my application to the scholarship program for the sole purpose of vetting this application by the factory board and management.

Signature: ………………………………………………………………………… Date: …………………………………………………………………………..

Parent/Guardian declaration:

 

I,………………………………………………………………………………………… confirm that all the information provided is true and correct. I ac-

cept responsibility for any information found to be false / misleading. I authorize KTDA Foundation to obtain further informa- tion required to use and release information regarding my child’s application to the scholarship program for the sole purpose of vetting this application by the factory board and management.

Signature: ………………………………………………………………………… Date: …………………………………………………………………………..

Name: …………………………………………………………………………….. ID No: ………………………………………………………………………….. Relationship to applicant (father, mother, guardian etc) …………………………………………………………………………………………………

Address: ……………………………………………………………………… Mobile Number: ………………………………………………………………..

Head Teacher / Religious Leader / Area Chief / Assistant recommendation:

I have read the information provided by the applicant and parents/ guardians in this form. Based on the knowledge I have of the family and applicant I make the following recommendation;

1. Head Teacher: ……………………………………………………………………………………………………………………………………………………..

………………………………………………………………………………………………………………………………………………………………………………

 

………………………………………………………………………………………………………………………………………………………………………………

 

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

Mobile number: ………………………………………………………….    Signature and Stamp: …………………………………………………..

2. Religious leader/Pastor/Priest/Imam: …………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………….

……………………………………………………………………………………………………………………………………………………………………………

 

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

Mobile number: ………………………………………………………….                Signature and Stamp: …………………………………………………..

3. Area Chief /Assistant: ……………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………………………………………………………………………

………………………………………………………………………………………………………………………………………………………………………………

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

Mobile number: ………………………………………………………….                Signature and Stamp: …………………………………………………..