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Full Name(As in order of KCSE result slip):
Your E-mail:
Phone No:
ID No/Passport No:
Date of Birth:
Gender:
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Male
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Nationality:
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BURUNDIAN
DJIBOUTIAN
ERITREAN
ETHIOPIAN
KENYAN
OTHER
RWANDESE
SOMALI
SUDANESE
TANZANIAN
UGANDAN
Emergency Contact Persons (Parent/Guardian)
Full Name
Relationship
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AUNT
BROTHER
COUSIN
FATHER
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MOTHER
SISTER
SPOUSE
UNCLE
Mobile Number
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