In partnership with An Affiliate of Kenya Red Cross STUDENT APPLICATION FORM INSTRUCTIONS Please fill this form (print/BLOCK CAPITALS), using ink and return it or forward to the address as indicated at the bottom of the second page. PROGRAMMES (Indicate below your progamme of interest) Food & Beverage Sales & Service Certificate 1 year Food and Beverage Supervision & Operation Diploma 2 year Housekeeping and Laundry Operations Certificate 1 year Housekeeping Operations and Supervision Diploma 2 year Front Office Operations 2 year Culinary Arts (Food Production) Diploma 2 year Diploma Swiss Higher Diploma in International Hotel Management 3 year PERSONAL DATA: Mr/Mrs/Miss/Ms Surname First Name Other Names ID/Passport No Age □ Date of Birth (Day/Month/Year) Male □ Female Mailing Address County Nationality Postal Code Town Country Address for correspondence ( if different from the above) Home Phone Mobile Phone Alternative Mobile No Email Name: Father Occupation Mobile Mother Occupation Mobile Guardian Occupation Mobile Relation Mobile Contact person in case of emergency Name EDUCATION BACKGROUND Schools/Colleges attended 1. 2. 3. Course/Class Completed (From-to) Certificate/Qualification Attained PROFESSIONAL/WORK EXPERIENCE (Current or most recent at the top) Employer Job Title Main duties From/To 1. 2. Have you attended any professional training seminars, if so list: Please submit details of all previous work experience on a separate page, along with copies of any reference letters received. LEARNING SUPPORT Do you have a learning difficulty, disability, mental health issues or medical condition YES □ NO □ If ‘yes’ please outline your learning difficulty, disability, medical condition and/or health difficulty (this will not prejudice your application in any way). This information is needed to determine whether you would require any specific support during your studies. Do you have any special dietary requirements? Yes □ □ No If yes, please specify Languages: Mother Tongue: Level: Other: Who will pay your school fees? Level: □ Self Funded □ Family □ Sponsorship/scholarship Declaration and signature of the Applicant By signing this form I give my permission to BIHC to verify any information contained on this application. I also confirm the information on this form is true, complete and accurate and no information requested has been omitted. Signature: Date: Signature of Parent/ Guardian (For students under 18 years of age) Thank you for your application. We will invite you for an interview when you will be asked to present your original certificates. For More Information Call us on: Tel: 0719 050 000 or 020 3904000, Email [email protected] Website: www.bihc.ac.ke