SERIAL

NO…………………………………….
National Government Constituencies Development Fund Board,
SUNA WEST CONSTITUENCY,
PINY OYIE,
P.O Box 585-40400,
SUNA-MIGORI,
Kenya
| Cell: 0710444849
NG-CDF BOARD Email: cdfsunawest@ngcdf.go.ke | Website: www.ngcdf.go.ke

BURSARY APPLICATION FORM FY2023/2024

DATE______________________

NAME OF STUDENT ………………………………………….GENDER …………………………………..

REGISTRATION/ADM. NO. …………………………...POLLING STATION ……………………………….

CONTACT …………………..……………………

INSTITUTION…………………………………………………CAMPUS……………………………………

PART A: INSTRUCTIONS

(Please, read all the instructions carefully and fill in the form accurately)

1. This form is for secondary, middle-level colleges and universities.

2. Submit a duly filled application form to SUNA WESTNG-CDF office or any other designated
area
3. All sections of the form must be filled. The applicant MUST insert his/ her registration/
admission number as indicated.

COMPULSORY ATTACHMENTS:
i) National identity card/birth certificate/entry number and copy of parent/guardian
national identity card.
ii) Relevant academic certificate –K.C.S.E and transcripts - COLLEGE
iii) Admission letter, fee structure
iv) Attach death certificates of parents and your own birth certificate to proof kinship where
applicable.
4. This application is not a guarantee for a bursary award
5. Cheques will be written in favour of the institution named in PART C and not to individual
applicants names

PART B: SCHOOL/COLLEGE/UNIVERSITY DETAILS

a) Course Title e.g., B.Ed. (Arts)____________________________________________
b) Current Year of study (e.g. year I )_______________________________________
c) Year of commencement of study in this institution_____________________________

Vision: Equitable social-economic development countrywide

ISO 9001:2008
 National Government Constituencies Development Fund Board,
SUNA WEST CONSTITUENCY,
PINY OYIE,
P.O Box 585-40400,
SUNA-MIGORI,
Kenya
| Cell: 0710444849
NG-CDF BOARD Email: cdfsunawest@ngcdf.go.ke | Website: www.ngcdf.go.ke

PART C: FINANCIAL STATEMENT

1. Total fees payable for the whole year: Kshs_________________________

PART E: DECLARATION

1. STUDENT
I __________________________________________ hereby declare that the information given herein
is true to the best of my knowledge and hereby accept that any false information will automatically
disqualify my application.

Signature: ___________________I/D No_________________________________________

Cell No________________________________ Date: _______________________________

CHIEF/ASSISTANT CHIEF/RELIGIOUS LEADER/PRINCIPAL/ DEAN OF STUDENTS

I certify that the applicant is a resident of SUNA WEST Constituency, ..........................Ward,

…………….... Location, .......................................................Sub location and that I have checked all the
information given herein and hereby confirm that they are complete and true to the best of my
knowledge.

Comment on family financial status _____________________________________________

___________________________________________________________________________
NAME Signature/ Official Stamp Date

……………………………………. …………………………….. …………………….

______________________________ _________________________ ________________

PART F: FOR OFFICIAL USE ONLY BY SUNA WEST NG-CDF BURSARY SUB-COMMITTEE
Amount awarded (Kshs) …………………………………………………

Chairman Secretary

Signature _______________________________ _____________________________

Name _______________________________ _____________________________
Date _______________________________ _____________________________

Vision: Equitable social-economic development countrywide

ISO 9001:2008