3|1

4. CRITWD BY:
|MOI UNIVERSIT Y
ACCOUNFANT
UNIVERSTTYZCOECINANCI (0RSON)
NAAI:

lRANK
Lazsne
A/ O,
STANM/SIGN
SCHOOLOF AKT
SOCInt 4HNCES

O1024 90296
NAAE AiONL BankoF kNYA HRANCHMO UNIVERSILt BRAOH
ADDEESSJAfOeMU.ac ke
IOSTAL ADDKESS Po Box 3400 I'OSTA,
otoo
DEAN
SCHOOL OF ARTS
AND SOCIAL, 3CIENCES
UNIKSTIYYCOIAGE VERnCATION BY PRINCIPAL/DEAN OF STUDENTS): MOI UNVERSY
STAMI/SIGN
ONTAT 0425S058
6. STUDENTS DECLARATION:

Idecdare that the intormaliou given lherein is true to the besl of nny knowledzC.
STUDENTS
NAAME

SIGNATURE DATE

7. RELIGIOUS LEADER
leenily t:t the inforn:ationgiven alove is correet to the best of myknOwledke.
NAM SIGNATURE
STAM"

8. CHIEI/ASSISTANT CIIIEr

lcetty tl.t tlie inteormationzVen above is coTV lo tle est of uIy knowllee
NANIE SIGNATURE:
STAMP

anr

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