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Helb DATA COLLECTION Forms

helb DATA COLLECTION forms

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thomas
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99 views2 pages

Helb DATA COLLECTION Forms

helb DATA COLLECTION forms

Uploaded by

thomas
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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HIGHER EDUCATION LOANS BOARD

FIRST TIME DATA COLLECTION LOAN APPLICATION


FORM
2023
First Name ____________________ Index Number _________________
Middle Name __________________ Country_______________________
Last Name_____________________ Points ________________________
ID/No_________________________ SECONDARY
KRA PIN _____________________ Institution Name________________
Date of Birth __________________ Exam Year_____________________
Email Mobile No. _______________ Index Number__________________
Address _______________________ Country_______________________
County________________________ Grade ________________________
Constituency ___________________ Points _________________________
Ward_________________________
Parent`s
APPLICANT'S PERSONAL DETAILS- Marital Status__________________
APPLICANT Are you an orphan?_____________-
Nearest Public Primary __________ If Parent(s) deceased provide
Estate/Village __________________ 1.Death Certificate No.___________
Sub-location ___________________ OR Burial Permit No. ___________
Location_______________________ 2.Guardian/Sponsor/Public Trustee
County __________________ ______________________________
Constituency ___________________ Parent's Marital Details
Ward_________________________ FATHER
Level of Study _________________ First Name ____________________
Institution Name _______________ Middle Name___________________
Faculty/School_________________ Other Name ___________________
Registration No. _______________ ID No. ________________________
Year of Admission _____________ Year of Birth __________________
Current year of Study __________ Highest Level of Education ______
Year of Completion_____________ Mobile/Telephone ______________
Admission Category ____________ Father's Income________________
Course________________________ Gross Monthly Income ___________
Institution Details_______________ Business (Annual) _______________
Amount applied for_____________ Farming (Annual) _______________
Amount your family can raise towards Pension(Monthly) _______________
your fees?______________ Support from GoK relief___________
PRIMARY STUDIED KRA PIN _____________________
Institution Name _______________ Employed YES ( ) NO ( )
Exam Year ____________________ (IF) Occupation/Profession_______
Employer Name ________________
Employer Tel. no. _______________ Employer Postal Address __________
Staff no. _______________________ Employer PostalCode ____________
GUARANTORS 2
MOTHER SURNAME ____________________
First Name ____________________ FIRST NAME__________________
Middle Name___________________ OTHER NAME_________________
Other Name ___________________ ID No. ____________________
ID No. ________________________ Tel No ____________________
Year of Birth __________________ Box No____________________
Highest Level of Education ______ Post Code ____________________
Mobile/Telephone ______________ Email ____________________
Father's Income________________ County ____________________
Gross Monthly Income ___________ Constituency ___________________
Business (Annual) _______________ Ward ____________________
Farming (Annual) _______________ Location ____________________
Pension(Monthly) _______________ Sub-Location ___________________
Support from GoK relief___________ Year of Birth ___________________
KRA PIN _____________________ Employer Name _________________
Employed YES ( ) NO ( ) Employer Tel. No. _______________
(IF) Occupation/Profession_______ Employer Email_________________
Employer Name ________________ Employee No __________________
Employer Tel. no. _______________ Employer Postal Address __________
Staff no. _______________________ Employer PostalCode ____________
GUARANTORS 1
SURNAME ____________________
FIRST NAME__________________ BANK NAME _________________
OTHER NAME_________________ BRANCH _____________________
ID No. ____________________
Tel No ____________________ ACCOUNT NO_________________
Box No____________________
CONFIRM ACCOUNT NO:
Post Code ____________________
Email ____________________
County ____________________
Constituency ___________________
Ward ____________________
Location ____________________
Sub-Location ___________________
Year of Birth ___________________
Employer Name _________________
Employer Tel. No. _______________
Employer Email_________________
Employee No __________________

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