INTEGRATED FOUNDATION
OF NORTH RIFT
P.O BOX 4764- 30100 ELDORET Tel: 0723 776428/0780 776428
Email: northriftfoundation2020@gmail.com
www.integratedfoundationofnorthrift.co.ke
APPLICATION FORM – FINANCIAL EMPOWERMENT
NAME OF THE APPLICANT………………………………………………………….ID NO……………………………………………………
CONTACT………………………………SEX……………………..AGE………………MARITAL STATUS…………………………………….
NO OF CHILDREN……………...SECONDARY………………….PRIMARY.........…...COLLEGE…………………………………….
NO EMPLOYMENT………………………….ARE YOU EMPLOYED,YES/NO……………………WHERE…………………………..
NAME OF YOUR COUNTY…………………………………..SUB COUNTY………………………………WARD……………………….
LOCATION………………………………………..SUB LOCATION………………………………..VILLAGE………………………………..
NAME OF YOUR AREA:
CHIEF ………………………….CONTACT…………………..…ID……………………..CONTACT………………………..SIGNATURE
……………….…………….DATE……………………………………………….STAMP……………………………………………………………
Are you a Widow, Widower, Single, PWD, Orphan, Elderly. Do you have any source of income?
…………………………………………………………………….
Standard of Education; Year obtained…………………………………………any sponsor on fee payment (YES/NO)
Are you pensionable YES/NO
Documents to be attached;
i.
Letter from your area chief
ii.
Letter from your pastor (optional)
iii.
Copy of your ID, both sides
iv.
Amount applied for assistance KSHS…………………………………………..
v.
Amount approved for assistance KSHS……………………………………….
Official use
Name of your Foundation County chair
Person; …………………………………………………………………………………..
Contact;………………………………………..date…………………………………………….signature………………………………………
Name of your Foundation Sub-County official;……………………………………………………………………………………………
Contact;……………………………………………………………….date;………………………………….signature;……………………………….
FOUNDATION FINANCE COMMITTEE
Spiritual, Socio-Economic Empowerment Of Communities in Uasin Gishu, Elgeyo Marakwet, Nandi, Baringo,West
Pokot, Samburu, Tran-Nzoia, Laikipia and Turkana Counties
INTEGRATED FOUNDATION
OF NORTH RIFT
P.O BOX 4764- 30100 ELDORET Tel: 0723 776428/0780 776428
Email: north riftfoundation2020@gmail.com
www.integratedfoundationofnorthrift.co.ke
CHAIRPERSON ………………………………………………….ID NO…………………………………….CONTACT……………………………………….
SIGNATURE………………………………………………………….DATE………………………………………….
TREASURER………………………………………ID NO…………………………………………….CONTACT……………………………………………….
SIGNATURE………………………………………………………………DATE……….20…………….
SECRETARY……………………………………………………………….DATE………………………………………………………………
FOUNDATION FINANCIAL CONTROLLER
Funds Available/Not Available
SIGNATURE ……………………………………………………………………….DATE……………………………………………………………………
TRUSTEE/OFFICIALS
CHAIRPERSON……………………………………………………………ID NO……………………………………………………………………………….
CONTACT;………………………………………SIGNATURE;………………………………………………DATE;……………….20…………………..
TREASURER………………………………………………………………..ID NO……………………………......................................................
CONTACT……………………………………..SIGNATURE…………………………………………………DATE;………………20……………………
SECRETARY…………………………………………………………………ID NO…………………………………………………………………………………..
CONTACT……………………………………SIGNATURE…………………………………………………..DATE:………………..20…………………..
APPROVAL/NOT APPROVED
SIGNATURE………………………………………………………….CEO…………………………………………..DATE……………………………………….
Spiritual, Socio-Economic Empowerment Of Communities in Uasin Gishu, Elgeyo Marakwet, Nandi, Baringo,West
Pokot, Samburu, Tran-Nzoia, Laikipia and Turkana Counties.
INTEGRATED FOUNDATION
OF NORTH RIFT
P.O BOX 4764- 30100 ELDORET Tel: 0723 776428/0780 776428
Email: north riftfoundation2020@gmail.com
www.integratedfoundationofnorthrift.co.ke
BUSARY APPLICATION FORM HIGH SCHOOL ONLY
NAME OF THE STUDENT…………………………………ADM……………………SCHOOL……………………….
FEES PER YEAR……………………………………FEES……………..………OUTSTANDING …………………….
NAME OF YOUR COUNTY;………………………………………SUB COUNTY……………………………………
WARD……………………………LOCATION…………………………..SUB LOCATION………………………………
VILLAGE……………………………………………
NAME OF YOUR PARENT/GUARDIAN;………………………….…………………………….ALIVE/NOT ALIVE
IDNO;………………………CONTACT;……………………….SIGNATURE………………………….DATE…………
……….
DOCUMENTS TO BE ATTACHED.
1. Fees structure
2. Recommendation letter from your chief/Pastor
3. Copy of ID NO.S’, both parents and students birth certificate
4. Recommendation letter from school principal
Name of your AREA CHIEF……………………………….CONTACT………………….………..ID NO………………
SIGNATURE………………………………………..DATE……………………………& STAMP………………………
Amount applied for bursary KSHS; ………………………………………………………………………………………..
Amount approved KSHS……………………………………………………………………………………..
OFFICIAL USE ONLY
NAME OF THE FOUNDATION COUNTY CHAIRPERSON………………………………ID NO………………………
SIGNATURE……………………………….CONTACT …………………….……….DATE……………………………..
Spiritual, Socio-Economic Empowerment Of Communities in Uasin Gishu, Elgeyo Marakwet, Nandi,
Baringo,West Pokot, Samburu, Tran-Nzoia, Laikipia and Turkana Counties.
INTEGRATED FOUNDATION
OF NORTH RIFT
P.O BOX 4764- 30100 ELDORET Tel: 0723 776428/0780 776428
Email: north riftfoundation2020@gmail.com
www.integratedfoundationofnorthrift.co.ke
NAME OF THE FOUNDATION SUB –COUNTY OFFICIAL…………………………..ID NO…………………………
SIGNATURE………………………………….CONTACT…………………………………DATE……………………….
FOUNDATION FINANCE COMMITTEE
CHAIRPERSON………………………….ID NO……………………….CONTACT……………………………………
SIGNATURE……………………………………………..DATE……..20………..
TREASURER………………………….ID NO…………………………………CONTACT…………………………….
SIGNATURE……………………………………………………DATE…………….20………..
SECRETARY…………………………………………………………………DATE………………………………………
FOUNDATION FINANCIAL CONTROLLER
Funds Available/Not Available
SIGNATURE………………………………………………….DATE………………….20…………
TRUSTEE/OFFICIALS
CHAIRPERSON………………………………..ID NO…………………………..CONTACT…………………………
SIGNATURE…………………………….DATE………..20…………
SECRETARY……………………................................ID NO……………………………..CONTACT…………………
SIGNATURE………………………………………………………….................DATE…………………………………
AMOUNT APPROVED/NOT APPROVED
SIGNATURE……………………………………..CEO………………………………………….DATE…………………
Spiritual, Socio-Economic Empowerment Of Communities in Uasin Gishu, Elgeyo Marakwet, Nandi,
Baringo,West Pokot, Samburu, Tran-Nzoia, Laikipia and Turkana Counties.