MTTI/REG/REGISTRAR/REGISTRAR/02
MINISTRY OF HIGHER EDUCAT ION SCIENCE AND
TECHN OLOGY
MUKIRIA TECHNICAL TRAINING INSTITUTE
PO BOX 1093 – 60200, MERU
MAIL: mukiriatechnical@gmail.com
Website www.mukiriatechnical.ac.ke
TEL: +254 716674848
STUDENTS’ APPLICATION FORM
Name of student……………………………………………………………………………….ID no…………………………………
Tel……………………………………………………………………………Date of birth………………………………………………
County………………………………………………….Constituency…………………………………………………………………
Location…………………………………………………Sub-location…………………………………………………………………
Village/Estate………………………………………..Nearest police station………………………………………………….
Course applied for……………………………………………………………………………………………………………………….
Father’s name…………………………………………………………ID………………………………………………………………..
Address……………………………………………………………………………………Tel. No……………………………………….
Deceased/Alive………………………………………………Occupation…………………………………………………………
Mother’s name……………………………………………………….ID……………………………………………………………….
Address…………………………………………………………………………………..Tel. No………………………………………
Deceased/Alive………………………………………………..Ocupation………………………………………………………..
Name(s) of brother(s) and sister(s). State whether working or in school/college
Name…………………………………………………………………..working/school/college………………………………….
Name…………………………………………………………………..working/school/college………………………………….
Name…………………………………………………………………..working/school/college………………………………….
DECLARATION
I……………………………………………………………………………..ID no…………………………hereby declare that I will abide
by the Institute rules and regulations.
Signed…………………………………………………………….Date……………………………………………………..
For official use: Date of admission……………………………………..Adm. No………………………………………..