MANDELA S.S, HOIMA

ONLINE APPLICATION FORM

MANDELA SECONDARY SCHOOL – HOIMA
STUDENT’S PERSONAL DATA FORM
“Caring to Achieve”


Student Details

Name:

Class: Year:

Sex: Age: Date of Birth:

LIN:

NIN:

Address:

Father’s Details

Name:

NIN:

Occupation:

Address:

Tel: Email:

Mother’s Details

Name:

NIN:

Occupation:

Address:

Tel: Email:

Guardian’s Details (If Any)

Name:

Occupation:

Address:

Tel: Email:

Other Information

Residence while schooling:


Any disability / health problem:


Hobbies:


Games played:


Who pays school fees? Contact:

P.L.E Results

Index No: Year:

Primary School:

Grades (English, MTC, Science, SST, Total Agg, Div):


U.C.E Results

Year: Index No:

Former School:

Grades (ENG, MTC, BIO, CHEM, PHY, HIS, GEOG, CRE, ENT, AGRI, ICT):


Declaration

I confirm that the information given on this form is correct to the best of my knowledge.

Student’s Name & Signature:

Parent’s Name & Signature: