National Government Constituencies Development Fund
SOUTH MUGIRANGO Constituency
P. O BOX
KISII
Tel:............................| Cell: 0725912723
Email:ngcdfmugirango@[Link]|Website:[Link]
NG-CDF SOUTH MUGIRANGO
BURSARY APPLICATION FORM SN. 665776007
Names JAKOYOMAXWELLOM
Gender M
PWD? N
ID/Birth/PP No. 665776007
Institution KENYATTA UNIVERSITY
Admission No. N38/6184/2025
Year of study 1
Semester 1
Course Duration 4
Mobile Number +254115727520
Email ID jakoyomaxxy@[Link]
Ward MOTICHO
Location OTENDO
Sub Location NYABERA
Village
Level of Study UNDERGRADUATE
Mode of Study FULL TIME
Family BOTH PARENTS ALIVE
Income (Father) NO SPECIFIC SOURCE OF INCOME
Income (Mother) NO SPECIFIC SOURCE OF INCOME
Date of Application 2025-12-22 14:47:03
Note: This form should be presented IN PERSON during the annual university/ college students meeting. You will be required to sign
and produce this form togther with a copy of 1). Your id card or birth certificate 2) Your student ID or admission letter. The attachments
are required for our verificatons to filter ghost applicants. Failure to attach the said copies will lead to automatic disqualification
STAMP......................... SIGN..........................
CHIEF (OTENDO LOCATION ) JAKOYOMAXWELLOM
I, Chief (OTENDO location ), do ascertain that I, JAKOYOMAXWELLOM , declare that the
the above information is true to the best of my above information is true to the best of my
knowledge knowledge