National Government Constituencies Development Fund Board
Turkana South Constituency,
Turkana South NGCDFC Office located next to DCC Office Lokichar NEXT to
KPLC Power Station-Lokichar,
P.O Box 267 – 30500,
Lodwar, Kenya.
Tel: Cell: 0770 072 945
Email: ngcdfturkanasouth@[Link] | Website:[Link]
NG-CDF BOARD
BURSARY APPLICATION FORM FY -2025/2026
CATERGORY OF APPLICATION (Tick as Applicable)
Secondary ( ) College ( ) University ( ) Others------------------------
_______________________________________________________________
INSTRUCTIONS TO APPLICANT
Please read all the instructions carefully and fill the form accurately
1. This form is for SECONDARY SCHOOLS, MIDDLE -LEVEL COLLEGES andUNIVERSITIES
2. Submit a duly filled applications to NG-CDF Turkana south offices is in Lokichar
3. All sections of the form must be filled
4. COMPULSORY ATTACHEMENTS
a) Copy of student Identity card/ National Identity card of parents
b) Copy of Relevant Academic Certificates, Report form or college Transcript
c) Copy of Admission letter, fees structure and fee balance statement from the institution
d) Copy of death certificate of parents and birth certificate to proof kinship where applicable
5. This application is NOT A GUARANTEE for a bursary award
________________________________________________________________
FOR OFFICIAL USE ONLY Received by-------------------------- Reg No-----------------
Signature---------------------------------Date----------
PART A :PERSONAL DETAILS ,INSTITUTIONAL AND OTHER DETAILS.
NAME OF STUDENT-------------------------------------------------------------------------------
Reg/Adm NO------------------------------------ID NO (where applicable) -----------------
Student NEMIS NO-------------------------------Tel Number------------------------------
Gender ( ) Male ( ) Female Date of Birth (DD/MM/YY)-------------------
Place of birth (Residence) Constituency--------------------------ward--------------------
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Location---------------------------Sub Location-------------------------Village------------
Name of school/ college/ University---------------------------------------------
Institution Code provided by Ministry of education (Secondary School) ----------------
Campus/Branch--------------------------------Level of study () Degree ( )dip ( )cert)
Course of study----------------------------------------------------------------------------
Mode of study: ( ) Regular ( )Parallel ( ) Boarding ( ) Day
Class/ Year of study___________ Expected year and month of completion______________
PART B: FAMILY BACKGROUND
Kindly indicate your family status: ( ) Total Orphan ( )partial Orphan ( )Both parents alive (
)single Parent Others ( State)----------------.
2. Please fill in the following details for your Parents/ guardian (if still alive);
Details Father/ Guardian Mother/
Guardian
Name
Occupation/ Profession
Main Source of Income
Others Source of Income farming,
business etc
Employed (Yes/No) Retired
Telephone Contact
3. Indicate the name of siblings in School/College/ Universities this year
Name Relationship School/ Class Total Fees Outstanding
institution Balance
Grand Total
PART C: APPLICANT'S ADDITIONAL INFORMATION.--------------------
[Link] are you applying for a bursary?.................................................
............................................................................................................................................................
............................................................................................
2. Do you suffer from any physical impairment (disability)? Yes( ) No ( )
3. Do you suffer from any other Disability of any chronic illness? Yes ( ) No ( ) If yes,
describe the disability …………………………………….
4. Does any of your parents/ guardians have any form of disability? Yes ( ) No ( ) If yes,
describe the disability............................................................…
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PART D: EDUCATON FUNDING HISTORY.
1. State the main source of education funding in the past (Fill where applicable)
School Source of Funding Other Source of funding
Secondary School
College
University
2. How much are you applying for---------------------------------
STUDENT’S /PARENT’S/GUARDIAN’S DECLARATION
Applicant’s Declaration: I hereby declare that the information provide herein is true to the
best of my knowledge and belief, and I understand that any false information provided shall
lead to my automatic disqualification by the committee.
Applicant’s Full Name..............................................................................
Adm / Reg No------------------------------ID No----------------------------------
Date--------------------------------Signature..............................................
Parent/ Guadian Declaration I hereby declare that the information provide herein is true to
the best of my knowledge and belief, and I understand that any false information provided
shall lead to my automatic disqualification by the committee.
Guardian’s NameFull ............................................................................
Signature................................................................................................
Date..........................................................................................................
PART F:RECOMMENDATIONS:
a) Religious Leader Comment on the Students / Family/Parent Status
------------------------------------------------------------------------------------------
------------------------------------------------------------------------------------------
-------------------
Assessment of the applicant ( ) Very Needy ( ) Needy ( ) Not Needy
I declare that I know the contents of this application form and I hereby confirm that the
information herein is true to the best of knowledge
-------------------------- ------------------ ---------------
Name Signature Date& Official Stamp
b) Area Chiefs/ Assistants Comment on the Students / Family/Parent Status
------------------------------------------------------------------------------------------
------------------------------------------------------------------------------------------
Assessment of the applicant( ) Very Needy ( )Needy[]Not needy
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I declare that I know the contents of this application form and I hereby confirm that the
information herein is true to the best of knowledge
--------------------- ----------------- ----------------------
Name Signature Date& Official Stamp
FOR OFFICIAL USE ONLY (To be filled by NG-CDF Bursary Committee)
The form was duly filled and signed Yes ( ) No ( )
All supportive Documents have been attached Yes ( ) No ( )
Recommended for Approval ( )Not recommended for approval ( )Reason for non
approval...............................................................................................................................................
...............................................................................................................................................
Chairman............................................Date.........................................................
Secretary................................................Date.........................................................
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