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Personal Details

Full Name * Please enter your full name.

Email Address * Please enter a valid email address.

Phone Number * Please enter your phone number.

Date of Birth * Please enter your date of birth.

Gender * Please select your gender.

ID Type * Please select ID type.

ID / Passport Number * Please enter your ID number.

Programme & Special Needs

Programme Applying For * Please select a programme.

Subjects Chosen (Please list the subjects you wish to study) * Please enter your chosen subjects.

Special Needs or Disabilities

Mode of Study * Please select your preferred mode of study.

Parent / Guardian Details

Parent / Guardian Full Name * Please enter the parent/guardian name.

Parent / Guardian Phone * Please enter the parent/guardian phone.

Parent / Guardian Email

Document Attachments

KCPE Certificate (PDF/Image) (Optional)

Birth Certificate or National ID (PDF/Image)

Passport Photograph (Optional Image)

I declare that all information provided is accurate and complete. I understand and accept the rules and regulations governing students of Clevers College.

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