PRIDE COLLEGE SCHOOL
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MPIGI
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PRIDE COL
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MPIGI
“ The Odyssey of academic pride”
OTHER S I CA N Located at Lungala - Mpigi, Masaka Road
CAN [Link] 70343, Kampala Tel: 0785 480 480 / 0760 689 165
Email: info@[Link] Website: [Link]
1. Name of student
2. Class to be admitted to: Attach 4
3. Date of Birth: Nationality: Pass Port size
4. Religious affiliation: Photos
5. Former school:
6. PLE Results for S.1(S.2 & S.3 Attach a report card for a previous year)
Math English
S.S.T Science Total Aggregates:
7. Index Number LIN
8. UNEB Learner’s ID
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EG
9. UCE Results (For S5 Please attach Passlip/Recommendations)
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PRIDE COL
10. Parents / Guardians Data:
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Name:
Attach 2
MPIGI
Occupation: Residence: Pass Port size
Place of work: Photos for
Contacts: the guardian
Office: Mobile:
NIN: Card No.
OTHER S I CA N
11. Next of Kin (State clearly)
Name: CANRelationship
Occupation: Residence:
Place of work:
Contacts:
Office: Mobile:
Email: NIN:
12. Do you have any health or dietary problem? Yes No
If yes, Specify:
13. How did you know about Pride College School - Mpigi?
“Others Can I Can”
I Parent / Guardian
Declare that the information given is true. I pledge to observe the rules and regulations laid down by the
school and to pay school fees and other school dues promptly.
Parent’s / Guardian’s name: Signature:
Date:
(1) Name of the Organization:
(2) Student registered and admitted by:
(3) Class applied for:
(4) Fees to be paid:
Signature and stamp of the Bursary Organization
“Others Can I Can”