APPLICATION FORM FOR STUDENT AID

The information provided in this application should be complete and accurate. The
Declaration page must be signed and dated.

SECTION A:

1. Are you a new applicant or a continuing student? (Tick applicable option):

(i) Continuing Student (An applicant who has already began his/her course)
(ii) New Applicant (An applicant intending to begin their course)
 If you are a Continuing Student, you are required to fill Part 8.7 and Part 10 in
Section B of this form.

2. What are Type of student Aid are you applying for (Tick applicable option)?
(i) Scholarship
(ii) Loan
(iii) All the above
 If you are applying for (i) above, and do not qualify for a scholarship, are you
willing to accept a loan? ____________________________(Yes/ No)
 If you are applying for (ii) or (iii) above. You are required to fill part 11 in
Section B of this form.

3. Purpose of application (Tick applicable option):

(i) Pay for school tuition only.
(ii) Pay for Exam Fee Only
(iii) Pay for Upkeep (Accommodation, Transport and Related expenses). Please specify
(iv) All the above.

4. Total amount of Aid Sought: (state amount in Ksh.)

If tuition only, Fee per Year (Attach Certified Fee Structure): ________________________

If exam only, Exam Fee per sitting: (Attach Certified Exam Fee Structure)
________________________

If for upkeep related expenses please specify in table below and (Attach Certified Quotation
where available)

1
Expense Specifics/type Value

If aid sought is for all the above, attach certified copies of documents for each.

Maximum Financial Aid Sought (KShs.): ________________________________________

To support your Application please provide the following documents:

1. A recent passport-size photograph
2. Copy of Birth certificate
3. Two letters of recommendation
4. A personal statement/motivation letter describing the applicant’s career objectives,
aspirations, plans after graduation (in not more than 500 words)

2
SECTION B:
1. Student’s Information
Surname: ______________________________________________________________
Other Name(s): _________________________________________________________
National ID/Passport No: (attach copy) _______________________
PIN No. ______________________
If under the age of 18, provide: Birth Certificate No.: _________________________
Mobile Number: ___________________ Email Address: _______________________
Postal Address: __________________Code: __________________Town: _____________
Gender: _________________________
Marital status (Single, Single Parent, Married, Separated): _________________________

2. Current Area of Residence

County: ________________________ Constituency: _________________________
Town:__________________________ Location:_____________________________
Sub location: ________________________ Estate/Village: ______________________
House No.: ________________________
Nearest Public School: _______________________________________

3. Student's Course Details

Course under study/Applied for: (Tick as appropriate)
(i) CPA
(ii) ACCA
(iii) Bachelors’ degree in Accounting and Finance (Specify)
_______________________________________
(iv) Other course (Specify) _______________________________________

Start Date: _______________________________________

Institution: _______________________________________
Campus: _______________________________________
Faculty/School: _______________________________________
Expected Duration of study: _______________________________________

3
4. Educational Background
(Attach certified copies of relevant Result slips/certificates)

Level Year of Institution Grade Average Fee paid By: (Parent,

Completion Name Annual Fee Guardian, Bursary,
(Kshs.) e.t.c)
Primary
Secondary Overall
Grade:______
Mathematics
Grade:______
English
Grade:______
Tertiary

5. Next of Kin
Surname: ______________________________
Other Name: _____________________________________________
Relationship to Applicant: _________________________________________
ID No: ___________________________PIN No: ________________________________
Postal Address: ____________Code: __________________Town: ___________________
Email Address: __________________________________________________
Mobile Number: __________________________________________________
Alternative mobile phone number: ___________________________________
Occupation: __________________________________________________

6. Family Information
6.1 Are you dependent on your parent(s)/Guardian? (Yes/No) ______________
If YES, fill part (A) below.
6.2 Are you dependent on your spouse? (Yes/No) ______________.
If YES, fill part (B) below.
6.3 Do you have any children/dependant? (Yes/No) ______________.
If YES, fill part (C) below.

4
 (A) Parent’s/Guardian’s Information (Fill only applicable sections)

FATHER MOTHER GUARDIAN

Name: Name: Name:
ID No.: ID No.: ID No.:
PIN No.: PIN No.: PIN No.:
Date of Birth Date of Birth Date of Birth
Occupation Occupation Occupation
Father is (tick applicable option): Mother is (tick applicable option): Guardian is (tick applicable option):
o Employed o Employed o Employed
o Self-Employed o Self-Employed o Self-Employed
o Unemployed o Unemployed o Unemployed
o Retired o Retired o Retired
If Employed, provide: If Employed, provide: If Employed, provide:
Name of Employer: Name of Employer: Name of Employer:
_________________________ _________________________ _________________________
Address of Employer: Address of Employer: Address of Employer:
__________________ __________________ __________________
Employer’s Telephone Number: Employer’s Telephone Number: Employer’s Telephone Number:
_________________ _________________ _________________
Employee Number: Employee Number: Employee Number:
__________________ __________________ __________________
Level/ Role/Position: Level/ Role/Position: Level/ Role/Position:
__________________ __________________ __________________

If self-employed provide: If self-employed provide: If self-employed provide:

Name of Business: Name of Business: Name of Business:
_________________________ _________________________ _________________________
Address of Business: Address of Business: Address of Business:
__________________ __________________ __________________
Location of Business: Location of Business: Location of Business:
__________________ __________________ __________________
Type of Business: Type of Business: Type of Business:
__________________ __________________ __________________
If retired, Provide: If retired, Provide: If retired, Provide:
Name of Last Employer: Name of Last Employer: Name of Last Employer:
________________ ________________ ________________
Address of Last Employer: Address of Last Employer: Address of Last Employer:
__________________ __________________ __________________

5
Year of retirement: Year of retirement: Year of retirement:
__________________ __________________ __________________

Average Annual Income: _______
Employment: ____________
Business: ____________
Farming: ____________
Pension: ____________
Other Income: ____________
Family Assistance: ____________
Support from GoK Relief Service:
____________
Savings: ____________
Average Annual Income: _______
Employment: ____________
Business: ____________
Farming: ____________
Pension: ____________
Other Income: ____________
Family Assistance: ____________
Support from GoK Relief Service:
____________
Savings: ____________
Average Annual Income: _______
Employment: ____________
Business: ____________
Farming: ____________
Pension: ____________
Other Income: ____________
Family Assistance: ____________
Support from GoK Relief Service:
____________
Savings: ____________

Inheritance: ____________ Inheritance: ____________ Inheritance: ____________

Income from other sources: Income from other sources: Income from other sources:
____________ ____________ ____________

6.4 Do your parent(s)/Guardian have any other dependant(s) apart from you? (Yes/No)
______________
If YES, fill the table provided below (add rows if necessary)

Name Age Relationship School/Employer Fee P.A: Class/Form School Fee

(How are they (if in Paid by: (If
related to school) in school)
you?)

6
 (B) Details of Spouse

Name:
ID No.:
PIN No.:
Date of Birth
Occupation
Spouse is (tick any applicable option):
o Employed
o Self-Employed
o Unemployed
o Retired
If Employed, provide:
Name of Employer: _________________________
Address of Employer: __________________
Employer’s Telephone Number: _________________
Employee Number: __________________
If self-employed provide:
Name of Business: _________________________
Address of Business: __________________
Location of Business: __________________
Type of Business: __________________
If retired, Provide:
Name of Last Employer: ________________
Address of Last Employer: __________________
Year of retirement: __________________

Average Annual Income: __________________

Employment: ____________
Business: ____________
Farming: ____________
Pension: ____________
Other Income: ____________
Family Assistance: ____________
Support from GoK Relief Service: ____________
Savings: ____________
Inheritance: ____________
Income from other sources: ____________

7
 (C) Details of Dependents

Name Age Relationship: School/Employer Fee P.A: Level of School Fee Paid
(How are they (if in Study by:
related to school)
you?)

8
7. Family Expenses
(Indicate estimated Family Monthly Expenses in Ksh.)
Food: ______________________________
Clothing: ______________________________
Rent: ______________________________
Travel/Fuel: ______________________________
Medical: ______________________________
Mortgage/Loan Repayment: ______________________________
Other Expenses (apart from education expense):
Other Expense Amount (KShs)

8. Additional Information
8.1 Are you physically challenged (E.g. visually-impaired, physically-impaired, etc.)?
(Yes/No): ___________
If YES, Please Specify___________________________________________________

8.2 You are (tick any applicable option):

(i) Employed
(ii) Self-Employed
(iii) Unemployed

If employed, provide:
Name of Employer: ________________________________________
Address of Employer: _____________________________________________
Employer’s Telephone Number: ____________________________
Employee Number/ID: ________________________________
Average Monthly Income (Attach pay slip): ____________________________
Do you intend to undertake the course on full-time or part-time basis?
________________________________________________
Do you intend to continue working? ______________________________

If self- employed, provide:

Name of Business: ________________________
Address of Business: ________________________
Location of Business: ________________________
9
 Type of Business: ________________________
Average Monthly Income (Attach bank/M-pesa statement): ___________
Do you intend to undertake the course on full-time or part-time basis?
_________________________________________________
Do you intend to continue with business? _______________________

8.3 Are any of your parents deceased? (Yes/ No) ______________

If Yes, Fill the table below and Attach copy of Death Certificate.

Parent Date of death

8.4 If both parents are deceased, who has been paying your fee? (Tick as appropriate)
(i) Guardian
Name: ___________________________________________
Telephone No.: ____________________________
Address: __________________________________________
(ii) Public Trustee
Name: ___________________________________________
Telephone No.: ____________________________
Address: __________________________________________
(iii) Other Sponsor. Specify: ______________________________
Name: ___________________________________________
Telephone No.: ____________________________
Address: __________________________________________
Relationship: ______________________________

8.5 Does any member of your family suffer from terminal/chronic illness? (Yes/No) _________
If YES, Please Specify:
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________

8.6 If Tuendelee Foundation offers partial financial aid, the applicants are required to raise a
percentage of the total amount sought, how much is your family/ guardian/ yourself able to
pay towards your education per Semester? KShs. ______________________

10
8.7 The Kenya Higher Education Loans Board (HELB) awards various amounts of loans to
university/college students with demonstrated financial need. All degree students seeking
financial aid must apply for a HELB loan through www.helb.go.ke and attach a copy of the
submitted HELB application form.
HELB No.: _________________________
HELB Loan Received per Year: KShs. ______________________________________
HELB Bursary Received (if applicable): KShs.___________________________________

*If you did not apply for the HELB loan, briefly explain reason:
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________

8.8 Applicants may already be receiving another form of financial aid, other than HELB loan
from other institutions and organisations to finance their studies. If so, Provide:

Type of Financial Aid Awarding Institution Amount (KSh.)

(Scholarship, Loan, Bursary
etc.)

9. Accommodation, Transport and Related Expenses

9.1 Do you have stable accommodation for the entire course? (Yes /No) _________________
If YES, where will you stay? (With family, with a relative, in a hostel, other)
__________________________________________
If Hostel, Provide name of Hostel: __________________________________________
If staying with a Relative/Other, Provide:
Name: _________________________________________________________
Postal Address: _____________________ ______________________________
Email Address: _______________________
Mobile Number: _________________________
Relationship to Applicant: __________________________________
If other, Specify: __________________________________________

11
 If No, how will you cater for your accommodation?
________________________________________________________________________

9.2 If studying outside Kenya, who will cater for your transport and related expenses (e.g. visa
application, insurance, air fare etc.)?
[For students admitted at a University/College outside Kenya]
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________

12
10. For Continuing Students
[Students already enrolled in a tertiary institution]

Year of Study/Part ____________________________

Semester/Section__________________________
Average grade to date: _________________________ (Attach transcripts/progress report)
Reason for applying for Financial Aid (e.g. death of parent/guardian/sponsor, illness,
retrenchment etc.):
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________

How have you been financing your studies in the past?

_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________

13
11. For Loan Applicants
(i) LOAN CONDITIONS
All loans must be reimbursed with an annual service charge of 5%. Two guarantors are
required to co-sign the loan agreement. The payback period is five years, starting at the
earlier of getting a job or six months after completion of course. Where a beneficiary drops
out the loan amount will be due immediately (if the beneficiary is a bad-leaver). However,
for a good leaver, the payment period and terms shall remain the same.

(ii) GUARANTORS

GUARANTOR 1
Surname: ________________________________
Other Name(s): ________________________________________________
National ID/Passport No: ________________________________
Mobile Number: ________________________________
Email Address: ________________________________
Postal Address: ________________Code: _______________Town: _______________
Current Place of Residence: ______________________________
Name of Employer: ________________________________________________
Address of Employer: ________________________________________________
Employer’s Telephone Number: __________________________________________
Employee Number: ________________________________________________
Percentage of loan you intend to guarantee: ___________________________

(also known as “the guarantor” hereby expresses my intention to bound to Tuendelee

Foundation in the sum of amount equivalent to the percentage agreed upon above of the
total sum that the Foundation shall grant as student loan to
________________________________________________ (Name of Applicant) and
interest thereon in the event that the loanee fails to honour his/her obligation of repaying
the same to the Foundation as from the prescribed time. The Foundation will notify me of
the amount of scholarship/loan to the loanee after the award is made, and only then shall a
binding agreement be signed.)

Signature: __________________________________

Date: _______________________________

14
GUARANTOR 2
Surname: ________________________________
Other Name: ________________________________
National ID/ Passport No: __________________________________
Mobile Number: ______________________________________
Email Address: ________________________________
Postal Address: ___________________Code: ______________Town: _______________
Current Place of Residence: ________________________________
Name of Employer: ______________________________
Address of Employer: __________________
Employer’s Telephone Number: __________________
Employee Number: __________________

(also known as “the guarantor” hereby expresses his/her intention to bound to Tuendelee
Foundation in the sum of amount equivalent to the percentage agreed upon above of the
total sum that the Foundation shall grant as student loan to
________________________________________________ (Name of Applicant) and
interest thereon in the event that the loanee fails to honour his/her obligation of repaying
the same to the Foundation as from the prescribed time. The Foundation will notify me of
the amount of scholarship/loan to the loanee after the award is made and only then shall a
binding agreement be signed.)

Signature: ____________________________________

Date: _______________________________

15
12. DECLARATION

I ________________________________________________ confirm that the information herein

provided is accurate. I accept the terms of application.

Applicant’s Signature: ________________________________________________

Date of Application: ________________________________________________

If applicant is under the age of 18 years:

I ________________________________________________ being parent/guardian/caregiver of

the applicant ________________________________________________ confirm that the

information herein provided is accurate. I accept the terms of application.

Parent/Guardian/Caregiver Signature: ________________________________________________

Applicant’s Name (Applicant to fill name him/herself):

________________________________________________

Date of Application: ________________________________________

16
CHECKLIST

A. Before submitting this application form, kindly confirm that you have provided the
following:
a. A personal statement/motivation letter describing the applicant’s career objectives,
aspirations, plans after graduation (in not more than 500 words);
b. A recent passport-size photograph
c. Completed and signed application form
d. Two Letters of recommendation
e. Any other document provided for in the application form:
1. Certified Fee Structure from University/College
2. Quotation for all non-tuition expenses
3. Result slips and certificates
4. Pay Slips/M-pesa/bank statements (proof of employment//self-employment)
5. Copy of filled and submitted HELB Application Form
6. Transcripts/progress reports (for continuing students).
7. Copy of Identification document (National ID card or Passport)
8. Copy of birth certificate

B. Incomplete applications will not be accepted.

17