KIBU/ADM.11.35….. KIBABII UNIVERSITY COLLEGE KIBABINIVERSITY (A Constituent College of Masinde Muliro University of Science and Technology) P.O. Box 1699-50200 Bungoma Kenya Tel: 020-2028660 / 0708-085934 / 0734-831729 E-mail: [email protected] Website: www.kibabiiuniversity.ac.ke ==================================================================== APPLICATION FOR UNIVERSITY HOUSE Two (2) of these forms should be filled and returned to the DP (PA&F), Kibabii University, P.O Box 1699 – 50200, BUNGOMA – KENYA. Name …………………………………………….…………………………………….. Designation…………………………………………… Pf. No………………………… Department ……………………………………………………………..……………… Marital Status…………………………………………………………………………. Family Size and Age of Children …………………………………………………….. NAME SEX DATE OF BIRTH a) ……………………………………… ……………………. ……………………... b) ……………………………………… ……………………. …………………….. c) ……………………………………… ……………………. …………………….. d) ……………………………………… ……………………. …………………….. e) ………………………………………. …………………….. …………………….. f) ………………………………………. …………………….. …………………….. 6. Indicate how many members of your family will accompany you. NAME SEX DATE OF BIRTH a) …………………………………… ……………………. ……………………. b) …………………………………… ……………………. …………………….. c) …………………………………… ……………………. ……………………… d) ……………………..……………. ……………………. ……………………… e) ……………………………………. …………………….. ……………………… f) …………………………………… …………………….. ………………………. 7. Type of accommodation preferred: Principal’s/Senior Staff/Middle Staff/Junior Staff Quarters. ................................................................................................................................................ 1. 2. 3. 4. 5. *NOTE: The Space Allocation Committee will consider the preferences in Item No.8 on the basis of available accommodation. 8. Location of the Accommodation Preferred (if any). ……………………………………………………………………………………………………… ……………………………………………………………………………………………………… 9. Applicant’s Signature …………………………………Date……………………………………
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