MKU/ADR/F002 Mount Kenya University Scaling the Heights of Education APPLICATION FORM READ THE APPLICATION INSTRUCTIONS BEFORE COMPLETING THIS FORM. COMPLETE ALL APPROPRIATE SECTIONS IN CAPITAL/BLOCK LETTERS AND RETURN WITH YOUR NON-REFUNDABLE APPLICATION FEE (See Fee Schedule) AND OTHER SUPPORTING DOCUMENTS TO: Mount Kenya University, Registrar, Academic Affairs P.O. Box 342-01000 Thika, Kenya Tel:+254 020 2088310; +254 0202338146/8 Fax: +254 020 2050315, Cell: +254 020790796; 0789126571 Email: info@mku.ac.ke; admissions@mku.ac.ke PLEASE WRITE IN CAPITAL LETTERS. 1. APPLICANT’S DETAILS FULL NAMES (as per secondary school certificates or equivalent) TITLE MR[ ] MRS[ ] MS[ ] GENDER Male[ ] Female[ ] DATE OF BIRTH NATIONALITY NATIONAL ID/PASSPORT NO COUNTY TOWN NEAREST TOWN 2. PERMANENT ADDRESS C/O P.O.BOX TELEPHONE Next of kin EMAIL TOWN CELLPHONE Address of next of kin 3. EDUCATIONAL BACKGROUND INSTITUTIONS ATTENDED FROM (YEAR) TO (YEAR) CERTIFICATE AWARDED 4. EDUCATIONAL PLANS (tick appropriate) 1. PROGRAMME APPLIED FOR Doctorate[ ] Masters[ ] Bachelors[ ] Diploma[ ] Postgraduate[ ] Diploma[ ] Certificate[ ] 2. PROGRAMME NAME (Combination/Option if any) 3. MODE OF STUDY(tick) Regular[ ] School Based[ ] Distance Learning[ ] Part Time[ ] Weekend[ ] Evening[ ] 4. PREFERED SEMESTER January[ ] April[ ] May[ ] August[ ] September[ ] December[ ] 5. CAMPUS WHERE STUDY WILL BE UNDERTAKEN Main Campus- Thika[ ] Nairobi[ ] Mombasa[ ] Eldoret[ ] Nakuru[ ] Nkubu/Meru[ ] Kitale[ ] Kigali[ ] Kakamega[ ] Lodwar[ ] Kisii[ ] Kabarnet[ ] Virtual[ ] Kisumu[ ] Garissa[ ] Malindi[ ] Hargeisa[ ] Mount Kenya University "Scaling the Heights of Education” ISO 9001:2008 Certified MKU/ADR/F002 6. FINANCING OF STUDIES Please Tick SELF[ ] PARENTS/GUARDIAN[ ] GOVERNMENT/HELB[ ] OTHER SPONSORSHIP[ ] IF OTHER PLEASE SPECIFY :…………………………………………………………………………………………….. 7. PREFERRED HOBBY 8. STATE WHETHER YOU HAVE ANY SPECIAL NEEDS THAT REQUIRE SPECIAL ATTENTION YES[ ] NO[ ] If YES, state the need:……………………………………………………………………………………………………………………………………………………. 9. INDICATE HOW YOU LEARNT ABOUT MOUNT KENYA UNIVERSITY Radio[ ] Television[ ] Newspapers[ ] Friends[ ] Others – State:…………………………………….. 10. ATTESTATION I hereby certify that the information given in this application is correct and complete to the best of my knowledge and hereby give my permission to the Directorate of Admissions and Registration to obtain any verification deemed necessary to process my application. I further certify that I will arrange for the forwarding of official transcripts as requested in the instructions, and that transcripts become the property of Mount Kenya University and will neither be forwarded to another institution nor returned to me. I will include with this application my application fee and other documents as required in the application instructions. Signature: …………………………………………………………………. Date: …………………………………………………………………………………………. SIGN YOUR APPLICATION FORM BEFORE RETURNING IT TO MOUNT KENYA UNIVERSITY. APPLICATION CHECKLIST 1. Non-refundable application fee (Kshs. 1,000 or US$ 50 for foreign students for Undergraduate and Kshs. 2,000 or US$ 100 for Postgraduate programmes. No cash payment*) 2. Duly filled and signed application form (please observe deadlines below). 3. Copies of all transcripts, Diplomas & Certificates. 4. One (1) recent passport size photograph (write your name on reverse side) 5. Copy of national I.D/Passport. ADDITIONAL REQUIREMENTS FOR INTERNATIONAL STUDENTS 1. An official translation of academic records (where language of study is not English) 2. A current financial guarantee letter 3. A completed immigration pass form (two forms enclosed) 4. Two(2) recent passport size photographs (write your name on reverse side) 5. Pass processing fee of Kshs 2000-No cash payment* *Payment is to be made in electronic money transfer, money order or bankers’ cheques payable to Mount Kenya University. Payment can also be made in the following bank accounts: a) b) c) d) e) f) g) h) i) Equity Bank Ltd Thika Branch, A/C number 0090292435067 payable at any Equity Bank Branch; Family Bank Ltd Thika Branch, A/C number 005000019336, payable at any Family Bank Branch; Guaranty trust Bank Thika Branch, (Formerly Fina Bank) A/C number 2014200002 payable at any Guaranty Trust Bank Branch. KCB Bank Thika branch, A/C number 1121032222 payable at any KCB Bank Branch Co-operative Bank Thika Branch, A/C number 01129279981300 payable at any Co-operative Bank Branch Standard Chartered Bank Thika Branch, A/C number 0102049817400 payable at any Standard Charted Bank branch Family Bank Thika Branch, A/C number 005000019336 payable at any Family Bank Branch NIC bank Thika Branch, A/C number 21200008796 payable at any NIC Bank Branch CCAS (for hostel payment):009020012357 REGISTRATION Students should be registered for classes prior to the beginning of any semester to avoid any late fees penalty. As a new student, you will have time to meet with the Registrar, Academics Affairs and complete registration procedures during the registration/orientation period. ONLY COMPLETE APPLICATIONS WILL BE PROCESSED. DEADLINES MUST BE OBSERVED FOR OFFICIAL USE ONLY APPLICATION NO:…………………………………………………..APPLICATION FEES RECEIPT NO./CHEQUE NO……………………………………………… DATE: …………………………….………………….. NAME: ………………….………………….. SIGNATURE ………………………….………………… MKU RESERVES THE RIGHT OF ADMISSION More information may be obtained from the Office of Registrar, Academic Affairs Mount Kenya University info@mku.ac.ke: www.mku.ac.ke Mount Kenya University "Scaling the Heights of Education”