Prin rintt Form
KENY
ERON
UTIC
L COLLEGE
Aviation House House compound, compound, KCAA Simulator Simulator Building, Building, P.O Box 6372-00200 Nairobi, Tel: +254-2-604559/604786/2132045 Mobile: 0722 990679, Email: Email:
[email protected] [email protected]
R RE EG GIIS ST TR RA AT TIIO ON N F FO OR RM M (USE BLOCK LETTERS)
Section 1
Name and Contact Information
FIRST NAME
DATE OF BIRTH:
MALE
AREA CODE TEL:
MIDDLE NAME
MONTH
FEMALE
DATE
YEAR
COUNTRY
OFFICE
OTHERS
SURNAME
NATIONALITY
ID NUMBER
PASSPORT NUMBER
POSTAL ADDRESS
HOUSE
POSTAL CODE
CELLPHONE
EMAIL
PARENT/GUARDIAN COUNTRY OF PERMANENT RESIDENCE: NAMES OF PARENT/GUARDIAN: PARENT/GUARDIAN OCCUPATION:
Section 2
Course details
STATE THE INTENDED COURSE OF STUDY (TICK ONE) Diploma In Aeronautical Engineering (Airframes And And Engines or Avionics) 1st Year
2nd Year
3rd Year
Tick The Year Enrolling In.
Diploma In Electrical Engineering (Electronic Option/Telecomm Option/Telecomm/Power /Power Option) Option) 1st Year
2nd Year
3rd Year
Tick The Year Enrolling In.
Diploma In Flight Operations & Dispatch Diploma in Air cargo Services & Dangerous goods Cabin Crew T r av e l an d T o u r i s m Sales and Marketing
Section 3 Current Qualifications and Work Experience 1. Current Studies
Are you studying?
Yes
No
If yes, write details below and indicate the results will be available Day
KENYA AERONAUTICAL COLLEGE –APPLICATION FORM YEAR 2010
Month
Year
1
Will you complete this course before commencing your new course at Kenya Aeronautical College? Yes No 2. Secondary School Studies Completed Years enrolled From:
To:
From:
To:
Institution
Name of Qualification
3. Post-Secondary (Tertiary) Studies Completed (e.g. Degree/Diploma)
Years enrolled From:
Section 4
Institution
Name of Qualification
To:
General Information
1. Are you also applying for a direct entry for aircraft maintenance engineer’s license program? (Yes/No) (Yes/No) 2. Do you intend to take a study course in engines overseas? Yes/No 3. State the mode of paying college fees (tick one) Per term
Per year
Installments
4. Will you be paying fees in us dollars, sterling pounds, or Kenyan shillings?
5. List any medical problems or special requirements_____________________________________________________
6. 6.
State the person who will be responsible for paying your tuition fees [ to to be filled by the respective party] Name Occupation _________________________________________________ Signature _____________________________ Address _____________________________________________________ Telephone ____________________________
Section 5
Attachments Declaration
The following items must be included to ensure your application is complete, incomplete applications applications cause delays in processing and may cause a hinder to the processing of the application form.
Certified Academic Transcripts Two academic referees Personal statement stating why you to want join Kenya Aeronautical College
A non-refundable Application fee of 1100 Ksh. NB: the promissory fee note should be signed by the above party and returned to the college before enrollment
I declare that to the best of my knowledge the information supplied in this application and the documentation supporting it is correct and complete. I acknowledge that the provision of incorrect documentation or withholding of documentation relating to my application may result in i n cancellation of enrollment by the institute. I understand that Kenya Aeronautical College reserves the right to discontinue di scontinue or later any course, subject or other arrangement without prior notice.
Applicants Signature/Name:
Date:
FOR OFFICIAL USE ONLY Received
Checked
Acknowledged
Action taken
KENYA AERONAUTICAL COLLEGE –APPLICATION FORM YEAR 2010
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