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<nav class="art-nav desktop-nav"><span style="color: #111111; font-family: roboto, sans-serif; font-size: 22px;">REPUBLIC OF KENYA</span></p>
<p><span style="color: #111111; font-family: roboto, sans-serif; font-size: 22px;">MINISTRY OF EDUCATION</span></p>
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<h3><strong>Scholarship Online Application Form</strong></h3>
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<div class="span12">Scholarship Application</div>
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<div class="ba-textInput tool"><label>(SCHOLARSHIP TITLE))</label><input name="5" type="text" placeholder="" data-type="regular" /></div>
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<div class="ba-textInput tool"><label>(NAME OF COUNTRY WHERE TENABLE)</label><input name="6" type="text" placeholder="" data-type="regular" /></div>
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<div class="ba-textInput tool"><label>1. Name in full ( Surname)</label><input name="7" type="text" placeholder="" data-type="regular" /></div>
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<div class="ba-textInput tool"><label>(Other Names)</label><input name="8" type="text" placeholder="" data-type="regular" /></div>
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<div class="ba-textarea tool"><label>2. Present mailing address</label><textarea name="9" placeholder=""></textarea></div>
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<div class="ba-textInput tool"><label>3. Present contact &#8211; (a) Telephone ((i) Landline:)</label><input name="10" type="text" placeholder="" data-type="regular" /></div>
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<div class="ba-textInput tool"><label>(ii) Mobile Phone No.</label><input name="11" type="text" placeholder="" data-type="regular" /></div>
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<div class="ba-textInput tool"><label>(b) Permanent Address</label><input name="12" type="text" placeholder="" data-type="regular" /></div>
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<div class="ba-email tool"><label>Email *</label><input name="14" required="" type="email" placeholder="" /></div>
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<div class="ba-textInput tool"><label>4. Age</label><input name="15" type="text" placeholder="" data-type="regular" /></div>
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<div class="ba-textInput tool"><label>Date of Birth</label><input name="16" type="text" placeholder="" data-type="regular" /></div>
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<div class="ba-textInput tool"><label>Sex</label><input name="17" type="text" placeholder="" data-type="regular" /></div>
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<div class="ba-textInput tool"><label>5. County</label><input name="18" type="text" placeholder="" data-type="regular" /></div>
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<div class="ba-textInput tool"><label>District of Birth</label><input name="19" type="text" placeholder="" data-type="regular" /></div>
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<div class="ba-textInput tool"><label>Constituency</label><input name="20" type="text" placeholder="" data-type="regular" /></div>
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<div class="ba-textInput tool"><label>6. Employers Details (if applicable) &#8211; Name</label><input name="21" type="text" placeholder="" data-type="regular" /></div>
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<div class="ba-textInput tool"><label>Address</label><input name="22" type="text" placeholder="" data-type="regular" /></div>
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<div class="ba-textInput tool"><label>Telephone</label><input name="23" type="text" placeholder="" data-type="regular" /></div>
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<div class="ba-textInput tool"><label>Designation</label><input name="24" type="text" placeholder="" data-type="regular" /></div>
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<div class="ba-textInput tool"><label>7. Do you have any dependants?</label><input name="25" type="text" placeholder="" data-type="regular" /></div>
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<div class="ba-textInput tool"><label>if yes, who will Support them if you are offered a scholarship?</label><input name="26" type="text" placeholder="" data-type="regular" /></div>
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<div class="ba-textInput tool"><label>8. What course do you wish to study?</label><input name="27" type="text" placeholder="" data-type="regular" /></div>
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<div class="ba-textInput tool"><label>9. Proposed future profession in Kenya</label><input name="28" type="text" placeholder="" data-type="regular" /></div>
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<div class="ba-textInput tool"><label>10. Schools or college presently attending</label><input name="29" type="text" placeholder="" data-type="regular" /></div>
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<div class="ba-textInput tool"><label>11. Do you plan to sit for nay examination this year?</label><input name="30" type="text" placeholder="" data-type="regular" /></div>
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<div class="ba-textInput tool"><label>12. Have you applied for admission into any institution of higher learning in Kenya? If yes, give details</label><input name="31" type="text" placeholder="" data-type="regular" /></div>
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<div class="ba-textInput tool"><label>13. Have you received a scholarship in the last two years?</label><input name="32" type="text" placeholder="" data-type="regular" /></div>
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<div class="ba-textInput tool"><label>If yes, state the sponsor and scholarship title</label><input name="33" type="text" placeholder="" data-type="regular" /></div>
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<div class="ba-textInput tool"><label>14. Institutions attended (i)</label><input name="34" type="text" placeholder="" data-type="regular" /></div>
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<div class="ba-textInput tool"><label>Date</label><input name="35" type="text" placeholder="" data-type="regular" /></div>
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<div class="ba-textInput tool"><label>Qualification</label><input name="36" type="text" placeholder="" data-type="regular" /></div>
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<div class="ba-textInput tool"><label>(ii)</label><input name="37" type="text" placeholder="" data-type="regular" /></div>
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<div class="ba-textInput tool"><label>Date</label><input name="38" type="text" placeholder="" data-type="regular" /></div>
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<div class="ba-textInput tool"><label>Qualification</label><input name="39" type="text" placeholder="" data-type="regular" /></div>
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<div class="ba-textInput tool"><label>(iii)</label><input name="40" type="text" placeholder="" data-type="regular" /></div>
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<div class="ba-textInput tool"><label>Date</label><input name="41" type="text" placeholder="" data-type="regular" /></div>
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<div class="ba-textInput tool"><label>Qualification</label><input name="42" type="text" placeholder="" data-type="regular" /></div>
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<div class="ba-textInput tool"><label>(iv)</label><input name="43" type="text" placeholder="" data-type="regular" /></div>
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<div class="ba-textInput tool"><label>Date</label><input name="44" type="text" placeholder="" data-type="regular" /></div>
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<div class="ba-textInput tool"><label>Qualification</label><input name="45" type="text" placeholder="" data-type="regular" /></div>
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<div class="ba-textInput tool"><label>(v)</label><input name="46" type="text" placeholder="" data-type="regular" /></div>
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<div class="ba-textInput tool"><label>Date</label><input name="47" type="text" placeholder="" data-type="regular" /></div>
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<div class="ba-textInput tool"><label>Qualification</label><input name="48" type="text" placeholder="" data-type="regular" /></div>
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<div class="span12"><input class="ba-btn-submit" type="submit" value="Submit" /></div>
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<p><a href="http://www.balbooa.com/joomla-forms">Joomla Forms</a> makes it right. Balbooa.com</p>
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<p>To quickly submit your application form, <strong><a href="https://www.education.go.ke/index.php/online-services/scholarship-application-form">click here.</a></strong></p>
<p>Note: Copies of academic certificates and testimonial must be emailed to <span id="cloakea624655a876a40e6a1a32e6a5e483e7"><a href="mailto:info@education.go.ke">info@education.go.ke</a></span></p>
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<h3 class="t">Complains/corruption or complements</h3>
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<form id="s5_quick_contact" method="post" name="s5_quick_contact"><span id="s5_qc_namebox_span" class="s5_qc_name_wrap"><input id="s5_qc_namebox" class="inputbox" name="s5_qc_name" type="text" value="Name..." /></span><span id="s5_qc_emailbox_span" class="s5_qc_email_wrap"><input id="s5_qc_emailbox" class="inputbox" name="s5_qc_email" type="text" value="Email..." /></span><span id="s5_qc_subjectbox_span" class="s5_qc_subject_wrap"><input id="s5_qc_subjectbox" class="inputbox" name="s5_qc_subject" type="text" value="Subject..." /></span><span class="s5_qc_spambox_wrap"><input id="s5_qc_spambox" class="inputbox" name="s5_qc_verif_box" type="text" value="Enter The Code..." /></span><span class="s5_qc_security_img_wrap"><img id="s5_qc_security_img" src="https://www.education.go.ke/modules/mod_s5_quick_contact/captcha/CaptchaSecurityImages.php?width=90&;height=30&;characters=5" /></span><span class="s5_qc_button_wrap"><button id="s5_qc_submitbutton" class="button btn art-button" type="button">Send Message</button></span></form>
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