THE KISUMU NATIONAL POLYTECHNIC

P.O.BOX 143-40100

FUNNERAL ATTENDANCE FORM

NAMEOF THE Bereaved: Admission Number:

Department: course:

Phone Number:

Names of students to attend the burial

1. Name: Admission Number:

2. Name: Admission Number:

Location of the burial:

Date of burial:

Approximate transport cost for each student:

Other necessary requirements:

Approved by;

Academic director: sign: date:

Dean of students: sign: date:

Principles Office: sign: date:

Cash office: sign: date: