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YALE HIGH SCHOOL

DAY & BOARDING - KAYUNGA


P.O. BOX 8087
KAMPALA UGANDA
Our Ref:

Your Ref:

Date:

VERIFICATION/CONSENT FORM

This serves to authorise the BEARER of this form to receive, on my


behalf, ORIGINAL/COPY of REPORT CARD/TRANSCRIPT/PASS
SLIP/CERTIFICATE or
OTHER :( please specify)

from Yale High School administration.

Name and Contact Information (OWNER)

Signature:

Name and address of RECEPIENT

Signature:

__________________________________________________________________
FOR OFFICIAL USE ONLY
Authorisation:
Dated:..

Please attach Passport Photograph before Stamping.

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