FORM MNU/1

MAMA NGINA UNIVERSITY COLLEGE

OFFICE OF THE REGISTRAR
ACADEMIC AND STUDENT AFFAIRS
Email: registrar-acad@mnu.ac.ke P.O. BOX 444-01030
Telephone: 020-208-4004 GATUNDU, KENYA

ADMISSION NUMBER: …………………………………………………

INFORMATION FOR NEW STUDENTS 2023/2024 ACADEMIC YEAR

Please read the information set down below carefully before you complete any on the attached
forms.

1. ARRIVAL AND REGISTRATION

(a) The registration of new students will take place at the Mama Ngina University College
grounds - Gatundu.

(b) All students MUST bring with them the original copies of letters offering them
admission into the Universtity College.

(c) They MUST also bring the following:

(i) Original and Photocopies of their academic certificates or result slips.
(ii) Original and Copy of the National Identification Card (ID) or Birth Certificate.

N/B No student will be registred without the documents mentioned in (b) and (c) ABOVE.

2. FINANCIAL REQUIREMENTS
The fees payable for the first semester is as indicated in the admission letter. All Students are
required to pay the fees before they are allowed to register into the University College. The fees
should be paid on or before the date of registration.

Payment must be paid in any of the account in any branch of the following banks in Kenya:
EQUITY BANK 0660282250603 MAMA NGINA UNIVERSITY COLLEGE
CO-OPERATIVE 01129556920900 MAMA NGINA UNIVERSITY COLLEGE

NB: Payment of fees by cash or cheque is not acceptable.

The fees is not inclusive of accomodation and meal charges

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DECLARATION OF ACCEPTANCE TO PAY FEES
I __________________________________________________ (Full Name of Parent/Guardian)
ID/Passport No. _______________________________________________________________
Parent/Guardian of ____________________________________________ (Full name of student)
Admission/Reference Number _________________________ who has been admitted to pursue a
course leading to degree of Bachelor of _______________________________________________
Accept to pay the required fees.

Signature of Parent/Guardian: __________________________ Date: ____________________

3. TRAVEL

Students are expected to make their own travel arrangments to the University College.

4. MEDICAL EXAMINATION

Admission into the University College is subject to a satisfactory Medical Report being received by
the Universtiy College. A student is therefore required to undergo a medical examination by a
recognized medical practioner before coming to the University College. This is very important
baseline information for a student’s health during his/her academic career and should be accurate and
exhaustive as possible.

Form MNU/4 is attached for this purpose. Please bring the form with you when you come for
registration and submit it to the University College Health Unit.

5. MEDICAL ATTENTION AT THE UNIVERSITY

The University College Health Unit is open to all students. However, parents/guardians are advised
to be prepared to meet all the expenses of any medical attention not provided by the Universtiy
College, bearing in mind that most Public Health Institutions have now institued cost sharing
measures.

6. OPTICAL AND DENTAL TREATMENT

The University College does not provide optical and dental treatment. Any student having or
suspecting to have problems should consult opticians and where necessary buy spectales before
coming to the University College. Similarly any student who might have dental problems should
consult dentists outside the University College for treatment.

7. STUDENT’S PERSONAL DETAILS – FORM MNU/6

The Office of the Registrar (ASA) would like to know as much as possible about each student to
enable the University College understand and serve each student better. For this purpose Form
(MNU/6) is provided. Please complete the form accurately and return it to the Registrar (ASA).

8. STUDENT IDENTIFICATION CARD

(a) After registration, each student will be issued with an identification card. You should be ready
to show it as may be required during your life at the University. In this connection you are
required to submit four 1” x 1” photographs to the Registrar (ASA) along with your letter of
acceptance. The photographs must be taken from a good studio noting that the University
College does not accept photographs taken from “photo-me” kiosks.
(b) Please note that the Identification card is an important University College document. Great
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 care should be taken not to lose it. Lending it to anybody else who is not authorized to use
the card is forbidden since you are the only person authorized to use your particular card.

9. NAMES

Please note that the set of names on all forms must be the same as the ones under which you registered
for your examinations. Change of names after registration at the Universtiy College will be permitted
only after producing an affidavit or Deed of Change of Name form an advocate or commissioner of
oaths effecting such a change. Such change of name is ONLY PERMITTED DURING THE
SECOND YEAR OF STUDY.

10. FOREIGN STUDENTS

Foreign students will pay full fees as may be determined by the Universtiy CollegeCouncil from time
to time.

11. THE UNIVERSITY COLLEGE CALENDAR

The University College Calendar stipulates academic regulations that will govern your academic career
as a student in this University College. You should ensure that you are fully conversant with the
relevant sections that concern your particular degree course and examinations.

12. STUDENTS’ HANDBOOK

Please make sure that you are familiar with the content of this document issued by the University
College during registration.

13. MATERIALS REQUIRED BY THE STUDENTS

Students are required to provide themselves with the following:

(i) Academic Stationery
(ii) Books and equipment (depending on the degree course one is registered for)
(iii) Clothing and pocket money.
(iv) Beddings (Bedcover, Blankets, Sheets, Bucket, etc.)
(v) Personal effects

14. SPECIAL REQUIREMENT

(i) Requirements for Bachelor of Science (Nursing) Students’ placement.

1. Full uniform and Name Tag (students to be guided by School of Health Sciences upon
registration)
2. White dust coat
3. Stethoscope
4. A pair of nurses scissors
5. A pen torch
6. A Nurses watch
7. Thermometer
8. Tape measure

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 9. Indexing by the Nursing Council of Kenya package

Item Cost (Kshs.)

Indexing Fee 5,000.00
Procedure Manual 3,000.00
Scope of Practice 250.00
Code of Conduct 250.00
Standards of Nursing Education and Practice 250.00
Bachelor of Science (Nursing) Training File 800.00
Convinience fee 50.00
Total 9,600.00

NB/ Payment is done directly to the Nursing Council of Kenya.

Students will be required to make the payment through mobile money during registration
under the guidance of the School of Health Sciences.

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 FORM MNU/2

MAMA NGINA UNIVERSITY COLLEGE

OFFICE OF THE REGISTRAR
ACADEMIC AND STUDENT AFFAIRS
Email: registrar-acad@mnu.ac.ke P.O. BOX 444-01030
Telephone: 020-208-4004 GATUNDU, KENYA

ADMISSION NUMBER: …………………………………………………

LETTER OF ACCEPTANCE TO ABIDE BY

UNIVERSITY COLLEGE RULES AND REGULATIONS

(To be completed and returned by those accepting the offer.)

Regulations Governing the Conduct and Discipline of the Student of the University College prepared
in accordance with the Universities Act and the Mama Ngina University College policies and guidelines
are reproduced here below. Read them carefully and confirm your willingness to abide by them by
signing at the end of this document.

REGULATIONS GOVERNING THE CONDUCT AND DISCIPLINE OF THE

STUDENT OF THE UNIVERSITY COLLEGE

1. DEFINITION OF STUDENT:

(a) All students who have been formally admitted to a course of study for an Undergraduate degree
within the University College.

(b) All occasional students who are registered students of another University or constituent College
but are admitted to courses of study within Mama Ngina University College.

(c) All postgraduate students who are registered for higher degree courses within the University
College.

2. PRINCIPAL’S POWERS

The regulations and control of students’ behavior shall be administered by the Principal on behalf of
the Council.

3. REGULATIONS

The following regulations shall apply to all students:

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(a) Motor Vehicle

A student may not keep a motor vehicle on University College premises without written permission
from the University College Management: Such permission will not be given without proof of a
current driving license, a valid tax license and current certificate of insurance. Such permission may
be refused or withdrawn without assigning any reason thereof.

(b) Responsibility of University College Property

A student or group of students will be held responsible for any damage of University College property
resulting from misuse or willful destruction of such property by the student or group of students.

(c) Academic Responsibility

Attendance of lectures, tutorials, seminars, practical, and other scheduled courses of instruction are
compulsory. The inability to attend classes for a week or more due to illness or any other acceptable
reason should be communicated to the Registrar (ASA) in advance detailing reasons for absence from
campus.

(d) Noise

It shall be an offence against University College regulations to create unreasonable noise or behave in
an unruly or rowdy manner to the disturbance or annoyance of other occupants of University College
premises.

(e) Loss of or Damage to Students’ Property

The University College disclaims all responsibility for losses of or damage to students’ property while
on University College premises.

(f) Fire Fighting Appliances

It shall be a serious offence against University College regulations to interfere with, damage or remove,
other than for firefighting purposes, any firefighting appliances.

(g) Procession and Demonstration

(i) It shall be a serious offence for any student or group of students whilst within the University
College to convene, organize, participate in any way, be involved in any demonstrations
gatherings or processions or in any unauthorized ceremonies, gatherings or demonstrations
for which permission has not been obtained from the university governing authorities.

(ii) It shall be a serious offence for any student or group of students to organize or participate in
pickets or in any manner prevent any student or member of staff from performing their normal
duties.

(h) Drunkenness

Whereas consumption of alcohol is not prohibited, drunkenness and disturbances of other students
because of drunkenness will constitute a serious offence.

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(i) Drug-taking and Possession of Drugs

It is a serious offence against University College regulations to possess or take drugs as a student of
this University College.

(j) Correspondence

(i) Correspondences to the press or other mass media by members of the University College in
their individual capacity, individual students or officials of the students’ organization and other
students should bear their individual names and their private address.

(ii) No student shall make any public statement on matters affecting the University College
without special authority form the Principal.

(iii) Correspondence by individual students or by officials of the students’ organizations (including

students’ societies) to representatives of foreign governments or other sponsoring bodies shall
be sent through the Office of the Head Students Affairs, who will forward as appropriate.

(iv) Invitation to Government Ministries, representatives of foreign governments or other

important persons to visit the University College in their official capacity shall be notified to
the University authorities in good time.

4. DISCIPLINARY PROCEDURES

(a) Academic Matters

(i) Within the Universities Act, the Charter and the Statutes empowers the Senate to discipline
all students on all academic matters. Such discipline includes: receiving and approving
recommendations from School Boards and Board of Examiners with respect to who
qualifies to sit for University Examinations.

(ii) Senate makes determinations on who repeats which year, breach of examination
regulations and who is to be discontinued from approved programmes of study. The
decision of the Senate is binding subject only to an appeal for review on the basis of fresh
evidence.

(iii) Breach of Examination Regulations

What Constitutes an Examination Offence or Irregularity?

a) Passing or receiving relevant verbal, written or electronic communication (relevant to the
examination) to or from other candidates or any other source during the examination-.
b) Unauthorized possession of used or unused examination answer booklet(s) outside the
examination room or unauthorized possession of used or unused examination answer
booklet(s) inside the room, other than the one issued during that particular examination.
c) Possession/having any unauthorized written, graphic or recorded material or otherwise, in the
examination room.
d) Copying and/or referring to other candidate’s answer booklets, or any other source e.g. parts
of the body, clothing etc.
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 e) Possession of any notes recorded on paper, parts of the body or clothing.
f) Possession and/or use of a mobile phone, i-pods, electronic note book or any unauthorized
electronic gadget(s) or source inside the examination room.
g) Returning examination answer booklets with written answers after the examination.
h) Plagiarism, i.e. falsely accessing another person’s work and appending one’s name and
signature claiming to be one’s own. This includes but not limited to copying other candidate(s)
written, published or unpublished material.
i) Disrupting the conduct of examinations.
j) Destroying evidence pertaining to examination irregularity.
k) Failure to write one’s registration number or deliberately writing the wrong registration
number on the answer booklet.
l) Presenting oneself for an examination in a unit which one is not registered for.
m) Claiming for marks in a unit one knows he/she did not register for and/or sit for the
examination.
n) Writing on the examination question paper.
o) Reading from other candidate’s answers scripts or question papers.
p) Permitting any other candidate to read or copy from one’s examination scripts.
q) Impersonation of other candidates or being impersonated during examination.
r) Deliberate failure or refusal to hand in the examination script at the end of the examination.
s) Assaulting and/or threatening an invigilator in the course of his/her duty.
t) Involvement in and/or influencing tampering with examination data.
u) Any other offence that is deemed to constitute an examination irregularity.

N.B: Involvement in any examination irregularity will automatically lead to expulsion

from the University College.

(b) General offences

The Senate Students Disciplinary Committee set up under the University Statues is composed of:

(i) Deputy Principal (AROSA) - Chairperson

(ii) Two student representatives (Students Association Chairperson and Academic Secretary)
(iii) One Senate Representative
(iv) Chairperson of respective Department
(v) Dean of respective school
(vi) Head of Students Affairs
(vii) Registrar (ASA) - Secretary

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The Committee deals with all examination irregularities and general offences committed by students
in their day to day activities within the University College other than the offences the University
College considers as major offences.

A student shall be given an opportunity of being heard before the Students Disciplinary Committee
makes its decision.

Under the Senate Students Disciplinary Committee, the penalties for the various general offences will
vary according to the gravity of the offence.

The penalties will include:

(i) Letters of warning which will be carried in the Students’ file.
(ii) Payment for damages.
(iii) Suspension from the University College for a Specific Period of time.
(iv) Expulsion from halls of residence where applicable.
(v) Expulsion from the University College.
(vi) A combination of any two or more of the above.
(vii) Any other penalties as the committee may deem fit.

(c) The Council shall have the right to expel a student from the University College without
reference to the students when a student commits any of the following:
(i) Boycotts lectures.
(ii) Maliciously or willfully damages University College property.
(iii) Violates regulations 3 (g) above
(iv) Assaults any member of staff in the discharge of official duties.
(v) Convicted by a Court of law for any criminal offence, which the Council shall deem serious
enough to warrant expulsion from the University College.

(d) State Security Matters

The sovereignty of the state Security Machinery to safeguard the sovereignty embraces the entire
republic, within which the University College falls. Accordingly, notwithstanding the existing
University College Machinery, the State Security Machinery cannot be faltered in the execution of its
functions and duties. Such machinery is outside the University College jurisdiction and any redress to
action taken to such powers should be sought from the Government without in any way involving
the University College.

5. VARIATION OF REGULATIONS

The Principal shall have the power to add to or/and vary regulations contained in Section 3 until the
next meeting of Council, but such addition or variation shall cease to have effect unless confirmed
by Council at such meeting.

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 DECLARATION BY STUDENT

This is to confirm that I DO ACCEPT the offer and I promise to abide by the Regulations
governing the conduct and discipline of the students of the University as spelt out in the regulations
above.

Candidates’ Name: ______________________________________________________________

(SURNAME) (OTHER NAMES)
Admission Number: _____________________________________________________________

Degree Admitted: _______________________________________________________________

School: _______________________________________________________________________

Department: ___________________________________________________________________

Signature: _____________________________________ Date: ___________________________

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FORM MNU/3A

MAMA NGINA UNIVERSITY COLLEGE

OFFICE OF THE REGISTRAR
ACADEMIC AND STUDENT AFFAIRS
Email: registrar-acad@mnu.ac.ke P.O. BOX 444-01030
Telephone: 020-208-4004 GATUNDU, KENYA

LETTER ACCEPTANCE OF OFFER BY THE CANDIDATE

(To be completed by those ACCEPTING the offer)

Dear Sir/Madam

With reference to your letter offering me a place in the School of …………………………………..

..………..…………………………………..……………………………………………………….
For a course leading to a degree of …………………………………………………………..……..
………………………………………………………………………………………………………

This is to confirm that I DO ACCEPT the offer, and I DO PROMISE TO ABIDE by the Rules
and Regulations governing the organization, conduct and discipline of Mama Ngina University College
as spelt out in the “Regulations Governing the Conduct and discipline of the Students of the
University”.

FULL NAME:
__________________________________________________________________
(SURNAME) (OTHER NAMES)

ID NO: …………………………………………………………………………………………….
P.O. BOX: …………………………………………MOBILE NO: ……………………………
ADMISSION NO: ……………………………………………………………………………….
DEGREE ADMITTED: ………………………………………………………………………...
SCHOOL: ………………………………………………………………………………………..
DEPARTMENT: ………………………………………………………………………………...
SIGNATURE ………………………………… DATE: ………………………………………..

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FORM MNU/3B

MAMA NGINA UNIVERSITY COLLEGE

OFFICE OF THE REGISTRAR
ACADEMIC AND STUDENT AFFAIRS

Email: registrar-acad@mnu.ac.ke P.O. BOX 444-01030

Telephone: 020-208-4004 GATUNDU, KENYA

LETTER OF NON-ACCEPTANCE OF OFFER BY THE CANDIDATE

(To be completed by those NOT ACCEPTING the offer)

Dear Sir/Madam,
Candidate’s Name: ______________________________________________________________
Admission No: ______________________________________________________________
With reference to your letter offering me a place in the School of ___________________________
_____________________________________________________________________________
For a course leading to a degree of _________________________________________________
This is to confirm that I WILL NOT ACCEPT the offer, because of the following reason(s):-

(Mark X against that which is applicable)

1. Family problems

2. Health issues

3. I have been offered an Overseas Scholarship

4. The University has not offered me the course I

applied for

5. I have taken on employment

6. Any other (state the reason here

Yours faithfully, ________________________________________________________________

(Surname) (Other Names)

Signature: ______________________________________ Date: __________________________

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FORM MNU/4

MAMA NGINA UNIVERSITY COLLEGE

OFFICE OF THE REGISTRAR
ACADEMIC AND STUDENT AFFAIRS
Email: registrar-acad@mnu.ac.ke P.O. BOX 444-01030
Telephone: 020-208-4004 GATUNDU, KENYA

Admission No………………………………

STUDENT’S ENTRANCE MEDICAL EXAMINATION

IMPORTANT : Students should bring this form duly signed during the registration.

NOTE: A chest X-ray may be required if the Doctor examines a sudent and feels that
it is necessary. The film should be given to the student to bring to the
University Medical Officer during the registration period.

PART 1:

(a) SURNAME ……………. FIRST NAME: ……………… OTHER NAMES ……………..

DATE OF BIRTH ……………………………… SEX ………………………………………….

KSCE Index No. …………………………………………………………………………………..
NATIONALITY: ………………………………… COUNTY ………………………………….
RELIGION: ……………………………………… SINGLE/MARRIED: ……………………
SCHOOL: …………………………………………………………………………………………
NAME, ADDRESS AND TELEPHONE NUMBER OF PARENT/GUARDIAN
……………………………………………………………………………………………………
……………………………………………………………………………………………………
………………………………………………………………………………………………………

NEXT OF KIN: …………………………………………………………………………………..

(b) Have you ever been admitted into a hospital? ………………………………………………….

If so, state reason for admision and date: …………………………………………………………...

………………………………………………………………………………………………………

(c) Have you had any of the following illness?

Tuberculosis or other chest infections Yes/No

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Fits, Nerveous disease or faining attacks Yes/No

Heart disease or rheumatic fever Yes/No

Any disease of genital-urinary system Yes/No

Allergic to food or drug Yes/No

Malaria Yes/No

Sexually transmitted disease Yes/No

If the answer to any of the above is YES, please give details with dates:
………………………………………………………………………………………………………
………………………………………………………………………………………………………
…………………………………………………………………………………………………

(d) If there are any other relevant details of your medical history not covered by the above, please
give particulars.
………………………………………………………………………………………………………
……………………………………………………………………………………………….............

(e) Has any member of your family suffered from

(i) Tuberculosis Yes/No

(ii) Insanity or mental illness Yes/No

(iii) Diabetes Mellitus Yes/No

(f) Have you been immunzed against any of the following diseases:-

(i) Small pox Yes/No Date: ………………………….

(ii) Tetanus Yes/No Date: ………………………….

(iii) Poliomylitis Yes/No Date: …………………………..

(iv) Corona Yes/No Date: ………………………….

Student’s signature: ………………………………………………………………………………

PART II (To be completed by the examining Medical Officer)

(a) Height ……………………………………………….. Weight: ………………………………

(b) VISUAL ACUITY

Without Glasses R.6/ L.6/

With Glasses R.6/ L.6/

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(c) Hearing Right Ear Left Ear

(d) Conditions of: Teeth ………………………………………………………

Nose ………………………………………………………...

Throat ………………………………………………………

(e) Lymphatic Glands …………………………………………………………………………..

a. Circulatory System ……………………………………………………………………..

b. Blood Pressure……………………………………… Pulse ………………………….

c. Systolic ……………………………………………… Diastolic ……………………..

( f) Respiratory System
………………………………………………………………………………

……………………………………………………………………………………………….........

X-ray Chest if necessary …………………………………………………………………………

……………………………………………………………………………………………………

……………………………………………………………………………………………………

THE STUDENT TO BE GIVEN THE CHEST – X-RAY FILM TO BRING TO THE

UNIVERSITY COLLEGE HEALTH UNIT DURING REGISTRATION

(g) Abdomen ……………………………………………………………………………………...

Spleen ……………………………………………………………………………….....
Any Evidence of Hernia ………………………………………………………………………….
(h) Urine …………………… Albumin ………………………………Sugar …………………….
(i) Any observation defects in addition to general record of observation.
………………………………………………………………………………………………………
………………………………………………………………………………………………………
……………………………………………………………………………………………………....
(j) Blook Khan Test ……………………………………………………………………………

(k) Any other obsevation of importance

………………………………………………………………..

Date: ………………………………………………………Signature: ……………………………..

Address: ……………………………..

Rubber Stamp: ……………………...

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PART III

(To be completed at the University College)

SPECIAL REMARKS

Fit/Unfit for University Education

Is/Is not on treatment at present

DATE: …………………………………………… SIGNATURE: ……………………………….

HEALTH OFFICER
MAMA NGINA UNIVERSITY

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 FORM MNU/5

MAMA NGINA UNIVERSITY COLLEGE

OFFICE OF THE REGISTRAR
ACADEMIC AND STUDENT AFFAIRS
Email: registrar-acad@mnu.ac.ke P.O. BOX 444-01030
Telephone: 020-208-4004 GATUNDU, KENYA

EMERGENCY MEDICAL OPERATIONS/ADMISSIONS

(For those students under 21 years)

Approval of your parents (or guardian in case none of your parents is alive) is required for the Principal
of Mama Ngina University College or his/her designate to give consent on their behalf, for an
emergency operation or admission into a hospital to be carried out on you should a situation calling
for such an operation or admission into a hospital arise.

FORM OF CONSENT

I agree that the Principal of Mama Ngina University College or his/her designate may consent to an

emergency operation, or admission into a hospital for my son/daughter if it has proved impossible to

contact me.

Name of student…………………………………………………………………………

Admission No of student………………………………………………………………..

Name of Parent/Guardian: …………………………………………………………………………

National Identity Card No: ………………………………………………………………………….

Mobile Number…………………………………………………………………………………….

Signature: …………………………………………………………………………………………....

Relationship: ………………………………………………………………………………………...

Address: ……………………………………………………………………………………………

Date: ………………………………………………………………………………………………

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FORM MNU/6

MAMA NGINA UNIVERSITY COLLEGE

OFFICE OF THE REGISTRAR
ACADEMIC AND STUDENT AFFAIRS
Email: registrar-acad@mnu.ac.ke P.O. BOX 444-01030
Telephone: 020-208-4004 GATUNDU, KENYA

STUDENT’S PERSONAL DETAILS

(To be completed in duplicate) AFIX A PHOTO

Information required in this form is intended to help the office of the Registrar (ASA) understand
the students better. It will be used for the purpose of improving the student’s welfare while at the
University.

1. Full Name:
…………………………………………………………………………………………
(SURNAME) (OTHER NAMES)

2. Admission Number: ………………………………………………………………..

3. Date of Birth: …………………………. Place of Birth ………………………………………

4. Sex: Male Female: (Tick appropriately)

5. Religion: ……………………………… National Identity Card No: …………………………

6. NHIF Card No: ……………………….. Postal Contact Address: ……………………………

7. Nationality: ……………………… Passposrt No: ………………….. Country: ……………...

8. Family Home Address: …………………………………………………… …………………

Sub-location: ……………………………… Name of Sub Chief : ……………………………

Ward: ………………………………….. …...Name of the Chief: ……………………………..

Sub County: …………………………………… County: ……………………………………

Mobile Phone Number: ………………………………… E-mail: ……………………………

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9. Marital Status

(a) Single/Married: ………………………………………………………………………...

(b) Name and Address of Spouse (if married) ……………………………………………..

10. Full name and Address of the Mother: ………………………………………………………...

Alive/Deceased: ………………………………………………………………………………

Occupation of Mother: ……………… Tel: ………………… Email: ………………………….

Full name and Address of the father: ……………………………………………………………

Alive/Deceased: ………………………………………………………………………………

Occupation of Father: …………………… Tel: ……………… Email: ………………………

11. Name and Address of Guardian (where applicable)

…………………………………………………………………………………………………

Occupation of Guardian: ………………………………………………………………………

Tel: …………………………. Email: …………………………………………………………

12. Names of siblings and dates of birth

Name Date of Birth

………………………………………… ………………………………………………………

………………………………………… ………………………………………………………

………………………………………… ………………………………………………………

13. Give names and address of three persons who can be contacted in case of emergency:

Name Relationship Address

(i) …………………. …………………… ………………………………………….

Tel: ……………………………… Email: ……………………………………

(ii) …………………. ……………………… …………………………………………

Tel: ……………………………… Email: ……………………………………

(iii) …………………. …………………… ………………………………………………

Tel: ……………………………… Email: ……………………………………

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14. Name and address of Secondary School (s) attended, Index number and dates

…………………………………………………………………………………………………
…………………………………………………………………………………………………
…………………………………………………………………………………………………
15. K.C.S.E. or Equivalent Results
Subject Grade Subject Grade
……………………….. …………………… ……………….. ………………………
……………………….. ……………………. ……………….. ………………………
………………………. …………………... ………………… ………………………
……………………….. …………………… ………………… ………………………
……………………….. …………………… ………………… ………………………
………………………… …………………… …………………... ………………………
………………………… …………………… …………………... ………………………
………………………… …………………… …………………... ………………………
KCSE INDEX NUMBER……………………………………………………………………….
16. Any other Institution/qualificataion: Qualification and Dates
……………………………………….. ………………………………...........................
……………………………………….. ……………………………………………....
………………………………………... ………………………………………………
………………………………………... …….........................................................................

17. Games/sports: Which games or sports are you intrested in?

Soccer: ……………. Hockey …………… Basketketball …………… Netball ………………

Lawn Tennis ……….. Athletics …………… Swimming ……………. Dart …………………...

Volleyball ………….. Badminton …………. Rugby ……………… Table Tennis…………….

Squash ………….. Martial Arts ……………….

If others specify ………………………………………………………………………………...

18. Did you represent your School in games/sports? If you did, in what capacity?

…………………………………………………………………………………………………

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19. Clubs, Societis and Hobbies: which clubs, societies or hobbies are you interested in?
Please give details of your partcipation.

…………………………………………………………………………………………………

…………………………………………………………………………………………………

…………………………………………………………………………………………………

20. Please give any information you think is useful for you to communicate to this University in
order to improve your welfare as a student.
…………………………………………………………………………………………………
…………………………………………………………………………………………………
…………………………………………………………………………………………………

21. Give any other information that might assist the University to know you better.
…………………………………………………………………………………………………
…………………………………………………………………………………………………
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22. I cerfity that the information I have provided is correct:

Signature: …………………………………………… Date: ………………………………

Shaping the Future

FORM MNU/7

MAMA NGINA UNIVERSITY COLLEGE

OFFICE OF THE REGISTRAR
ACADEMIC AND STUDENT AFFAIRS
Email: registrar-acad@mnu.ac.ke P.O. BOX 444-01030
Telephone: 020-208-4004 GATUNDU,KENYA

DECLARATION

I hereby undetake to complete the course for

which I have been accepted at Mama Ngina University College
unless I am requested to discontinue by the Universtiy College authorities.

I understand that change of School or Department will

be permitted only by authority of the University College.

I accept the regulations made from time to time

for the good order and governance of the University College
Lawfully made by Principal and
other duly appointed Officers of the University College.

Name of Candidate: ……………………………………………………………………………..

Admission No…………………………………………………………………………………….

ID No: ……………………………………………………………………………………………

Mobile Telephone Number……………………………………………………………………...

Signature: ………………………………………………………………………………………….

Date: ………………………………………………………………………………………………..

Shaping the Future