SWEC-F-1 SOTTUC WELFARE COMMITTEE BURSARY FORM. A. PERSONAL DETAILS 1. NAME…………………………………………………………………Reg No………………………………………………………. 2. Department……………………………………………………..Course…………………………………………………………. 3. Year of Study……………………………………………………Programme(JAB/SSP)………………………… 4. National ID NO……………………………………………(attach a copy of the ID) 5. E-mail Address……………………………………………... B. FAMILY DETAILS: 1. Father’s Name……………………………………………………..Occupation……………………………………. 2. Mother’s Name………………………………………………….Occupation……………………………………. 3. Guardian’s Name………………………………………………….Occupation…………………………………. 4. If both or one of the parents is not there, state reason e.g. Separation, Divorce, and Death……………… NB: i. Attach copy of no. 1 and no. 2 or no. 3 where applicable ii. Attach supporting document for no. 4 5. Siblings in High School: NAME SCHOOL/LEVEL/CLASS FEES PAYABLE C. FEES PAYMENT DETAILS: 1. Total Fees payable……………………………….. 2. Amount Paid/Able to raise: ……………………. 3. Outstanding Balance………………………………. 4. Who pays your School Fees? (Parent/Guardian/Sponsor)………………………….. 5. Do you receive HELB Loan? ................If yes, state amount……………………….. 6. Have you received Bursary from any fund? ..............  Amount from CDF: …………………………..  Amount from HELB: ………………………….  Other (Specify): …………………………………. _____________________________________________________________________________________ SOTTUC-SWEC P.O BOX 635-80300, VOI KENYA Page 1 SWEC-F-1 D. CLARIFICATION: Give reasons why you should be awarded Bursary/ why you consider yourself needy: ………………………………………………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………………………………………………… ……………………………………………………………………. E. APPLICANT’S DECLARATION: I declare that the information given herein is true to the best of my knowledge. Signature:………………………………………………….Date:………………………………………… F. OFFICIAL USE ONLY: 1. Verification by Finance Officer: Student’s Balance:……………………………….. Signature:……………………………………Date:……………………………. 2. Verification by the Dean of Students: Signature:………………………………………Date:………………. 3. Welfare Committee: AMOUNT AWARDED:…………………………………………… Committee Chairperson:……………………………..Date:……………………. Committee Secretary:…………………………………Date:………………………. NB: The committee will disqualify any applicant who will submit incorrect, false or misleading information. _____________________________________________________________________________________ SOTTUC-SWEC P.O BOX 635-80300, VOI KENYA Page 2