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AUTHETICATION OF ACADEMIC AND PROFESSIONAL CERTIFICATES PASSPORT

IN THE PUBLIC SERVICE

INDIVIDUAL OFFICER’S DATA CAPTURE FORM

PART (I)
OFFICER’S FULL
NAMES:____________________________________________________________________________________

PF NO:___________________________ DESIGNATION:____________________________________________________________

DATE OF 1ST APPOINTMENT:________________________________________________________________________________

CURRENT DATE OF PROMOTION:___________________________________________________________________________

CURRENT DATE OF REDESIGNATION:______________________________________________________________________

CURRENT STATION/OF DEPLOYMENT:_____________________________________________________________________

DATE DEPLOYED/TRANSFERRED TO CURRENT STATION:_________________________________________________

HIGHEST QUALIFICATION ATTAINED:

Academic e.g. KCSE, Bachelor’s Degree e.t.c.

(a) _______________________________________________________________________________________________________

(b) _______________________________________________________________________________________________________

Professional e.g. Fingerprint Course, C.P.A. e.t.c.

(a) _______________________________________________________________________________________________________

(b) _______________________________________________________________________________________________________

LAST SCHOOL/COLLEGE/UNIVERSITY ATTENDED_________________________________________________________

QUALIFICATIONS ATTAINED E.g. Bachelor’s Degree, Diploma, KCSE, KCPE:

(a) _______________________________________________________________________________________________________

(b) _______________________________________________________________________________________________________

(c) _______________________________________________________________________________________________________

YEAR ENROLLED/REGISTERED:____________________________________________________________________________

YEAR COMPLETED/GRADUATED: __________________________________________________________________________

Attached are certified copies of the originals and transcript (Human Resource offices to certify).

DATE:_________________________________________
SIGNATURE:_________________________________________________

NB: (1) Officers to submit his/her documents in person.

(2) Failure to submit may result in disciplinary action taken against the officer including immediate
stoppage of salary.

PART (II)

RECEIVING OFFICER (HUMAN RESOURCE TEAM)

NAME_______________________________________________________________________________________________________
DATE:______________________________________________SIGNATURE:____________________________________________

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