MMU/SAF/F 01

DEFERMENT/WITHDRAWAL FORM
COMPLETED IN FIVE (5) COPIES ONLY
PART A (1) DEFERMENTS OF STUDIES

I Mr./Mrs./Miss…………………………………………………… REG NO…………………………………

PROGRAMME…………………………………………………………..………………………………………
YEAR……………………SEMESTER…………………………... PHONE NO…………..…………………
wish to apply to be allowed to defer my studies from (Date)…………………………….to……………………
on account of the following (delete the inapplicable)
1. Short course outside the country
2. Ill health
3. Family problems
4. Financial difficulties (Attach fees statement)
5. Other problems (please specify here)____________________________________________________

SIGNATURE________________________________________ DATE_________________

PART A (II) – WITHDRAWAL FROM UNIVERSITY

I Mr./Mrs./Miss…………………………………………………… REG NO…………………………………

YEAR……………………SEMESTER…………………………... PHONE NO…………..…………………
Having considered all factors. I have decided to withdraw from the Maasai Mara University with effect from
(Date)……………….my main reason (s) for withdrawing is/are as follows (delete the inapplicable)
a. To transfer to another institution
b. Inability to cope with the course
c. Financial Problems
d. Personal and other social problems
e. If none of the above please indicate here below.
f. SIGNATURE_____________________________ DATE_________________
(B) CHAIRPERSON OF DEPARTMENT

I have assessed the request for deferment/withdrawal and recommend that the applicant may proceed to defer
/withdraw from the course with effect from (date) ________________to resume_______________. Upon
resumption, the student will join Year ___________________Semester ___________________.

SIGNATURE: ______________________________________ DATE_______________________

C) DEAN OF SCHOOL
I recommend that the applicant may proceed to defer/withdraw from the course with effect from (date)
__________________________________________ to ____________________________________

SIGNATURE: ______________________________________ DATE_______________________

(D) DEAN OF STUDENTS

I recommend that the applicant may proceed to defer/withdraw from the course with effect from (date)
__________________________________________ to ____________________________________

SIGNATURE_______________________________ DATE_______________________

(E) REGISTRAR, ACADEMIC AFFAIRS

The student has been granted permission to defer/withdraw from the University with effect from (date)
___________________to _________________________.

SIGNATURE__________________________________ DATE_______________________
 MMU/SAF/F 02

MAASAI MARA UNIVERSITY

LEAVE OF ABSENCE
SECTION C TO BE APPROVED BEFORE STUDENT DEPARTURE
SECTION A: TO BE FILLED BY THE STUDENT FIVE (5) COPIES
FULL NAME _______________________________________________________REGNO________________________________

ROOM RESIDENCE _______________________________________ PHONE NO________________________I

am requesting
to be granted leave of absence for ______________ days with effect from (date) ____________To
___________________ (date) on account of *sickness/Maternity/compassionate (Delete whichever is
applicable)
If other reasons other than the above stated please specify here below:

*Students on compassionate leave will be exempted from having signatures for HOD and
lecturers.
The following CATS/EXAMS are likely to be missed during this absence.
________________________
STUDENTS SIGNATURE
SECTION B
COURSE CODE COURSE TITLE LECTURERS NAME
_________________ ______________________ ________________________
_________________ ______________________ ________________________
________________ ______________________ ________________________
_________________ ______________________ ________________________
_________________ ______________________ ________________________
_________________ ______________________ ________________________
________________ ______________________ ________________________
_________________ ______________________ ________________________
_________________ ______________________ ________________________

SECTION B TO BE FILLED BY HEAD OF DEPARTMENT

SECTION C DEAN OF FACULTY/SCHOOL /INSTITUTE

I do recommend/not recommend ___________________________________leave days.
Signature_________________________ DATE_____________________________
Dean Faculty/Institute of ________________________________________________________
 DEAN OF STUDENTS
SECTION D

I do approve/not approve leave of absence for ____________________days from date________

To (date) ______________________________ *reasons for not approving (specify here below)

Signature___________________________ Date________________________________

cc Registrar Academics

Dean, Faculty/School/institute

Head of Department
 MMU/SAF/F 03

MAASAI MARA UNIVERSITY

BONAFIDE FORM

DATE: ____________________________________________

TO WHOM IT MAY CONCERN

This is to confirm that Mr./Mrs./Miss _______________________________________________

REG. NO. ______________________________________________ is a bonafide student of Maasai

Mara University

Kindly, please assist him/her.

Mohamed Adan
DEAN OF STUDENTS
 MMU/SAF/F 04

MAASAI MARA UNIVERSITY

STUDENT BONDING FORM
(TO BE FILLED IN TRIPLICATE)
NAME: ………………………………………………………………………………………………………
(Capital letters)
REG.NO…………………YEAR OF STUDY……………NATIONAL ID/PASSPORT NO……………..

Declare that I will abide by the Rules and regulations Governing the Conduct and discipline of the
students of Maasai Mara University. Undertake to respect the rights of others to pursue their education
and further promise to respect the rights and privileges of other members of the university community
and to desist from acts of vandalism on University, private and public property at all times.

If I do not abide by this bond, I will forfeit my place in the University and face any other legal
consequences that may be deemed necessary against me.

I solemnly swear.

SIGNATURE__________________________________DATE_______________
IN THE PRESENCE OF THE DEAN OF STUDENTS

NAME _______________________________ DATE ____________________________________________________

SIGNATURE RUBBER STAMP

C.C

1. PARENT/GUARDIAN (WRITE FULL ADDRESS AS PER YOUR OFFICIAL DOCUMENTS)

 MMU/SAF/F 021

MAASAI MARA UNIVERSITY (MMU)

GAMES AND SPORTS DEPARTMENT

REF: ______________________________ DATE: …………………………

FROM: The Director of Sports

Maasai Mara University (MMU)
TO:
………………………………………………………….
…………………………………………………………
SUBJECT: LOSS/DAMAGE OF SPORTS EQUIPMENT/ FACILITIES
You are hereby reminded that:-
1. You caused the loss/ damage of the following sports equipment/ facilities as per
Ref………………………………………………….
(i) ……………………………………………………………………………………...
(ii) ………………………………………………………………………………………
(iii) ………………………………………………………………………………………
(iv) ………………………………………………………………………………………
(v) ………………………………………………………………………………………
2. By copy of this letter therefore, you are required to immediately
………………………………………. (Repair/ replace) the above listed equipment / facilities
as per the MMU Rules and Regulations within SEVEN (7) days w.e.f the above date.
3. You shall be surcharged if you fail to…………………………………(repair/replace) the said
equipment / facilities by date…………………………………………………… in accordance
with Article 2.2.3 on page 8.

Thank you.

Games and Sports tutor

 MAASAI MARA UNIVERSITY

WORK- STUDY APPLICATION FORM

A. PERSONAL DETAILS

NAME………………………………………………………………………………

GENDER…………………………………………………………………………….

YEAR OF STUDY ………………………ADM NO.………………………………

PROGRAMME……………………………………………………………………..

HOME COUNTY …………………………………………………………………

MOBILE NUMBER …………………………………………………………….....

B. FAMILY BACKGROUND
a) Status of parent (tick as appropriate)
i) Both parents alive
ii) One parent alive
iii) No parent
iv) Single parent
v) Other (specify)………………………………….
b) Status of home (tick as appropriate)
i) Poor
ii) Fair
iii) Good
c) Occupation of parents
Father……………………………………………………………………….
Mother…………………………………………………………………......
Gurdian……………………………………………………………………

Tel. No: Father: ……………Mother……………... Gurdian……………..

d) Number of Siblings

i) In Primary School …………………………….

ii) In High School ……………………………

iii) In College/University ……………………………

iv) In Employment …………………………….

C. FINANCIAL AID

1. Higher Education Loans Board (HELB) loan

State the loans and bursaries received from HELB since joining University

Year 1: Kshs. ……………………………………….

Year 2: Kshs. ……………………………………….

Year 3: Kshs. ……………………………………….

Year 4: Kshs. ……………………………………….

2. Rattansi Bursary Fund (Indicate how much received)

Year 1: Kshs. ……………………………………….

Year 2: Kshs. ……………………………………….

Year 3: Kshs. ……………………………………….

Year 4: Kshs. ……………………………………….

3. Constituency Development Fund

(Indicate how much received)

Year 1: Kshs. ……………………………………….

Year 2: Kshs. ……………………………………….
Year 3: Kshs. ……………………………………….
Year 4: Kshs. ……………………………………….
 4. Work Study Programme

Indicate YES if you have participated in the programme …………

5. Current outstanding Fee balance

Kshs. ……………………………………………….

(NB Student Finance Officer to certify the above information)

Name……………………………………….………… Signature………………..

Date and rubber stamp………………………………….…………………………..

D. ACADEMIC PERFORMANCE/QUALIFICATION

i. KSCE SCORE………………………..

Previous year/semester performance in the University (indicate all units done)

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

DEAN OF STUDENTS/COMMITTEE’S COMMENTS

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

Provide a current fee statement stamped by student finance

E. What in your view, makes you qualified for a work study programme

…………………………………………………………………………………………………

Have you ever been presented for disciplinary since joining the University? If YES,

Explain

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

Issued by the Dean of Students Office

 MMU/SAF/F05

MAASAI MARA UNIVERSITY

MMUSA ELECTIONS
CLEARANCE FORM FOR A DELEGATE
DEPARTMENT OF …………………………..
NAME:…………………………………… REG. NO………………………………………

POSITION…………………………………………………

Dear Sir/Madam
COMPLIANCE CERTIFICATE
I …………………………………wish to present myself for the post of ………………………

1. CERTIFICATION BY: DEAN, FACULTY/SCHOOL/INSTITUTE OF

…………….……………………

I wish to certify that Mr. /Mrs. ……………………………has shown consistent and his/her
performance is 60% or above and I certify that his/her class work will not suffer by offering
him/herself for the post of a delegate.

NAME: _____________________SIGNATURE_______________ DATE/STAMP

2. CERTIFICATION BY : FINANCE OFFICE

I Certify that the above named have no outstanding fee balances for the previous academic years
and has paid 60% of the current semester.

NAME: __________________ SIGNATURE: ________________ DATE/STAMP

3. CERTIFICATION BY : SENIOR SECURITY OFFICER

I Certify that the above named have no criminal record or any continuing investigation

NAME: __________________ SIGNATURE: ________________ DATE/STAMP

DECLARATION
Having read and understand that MMUSA Constitution Article 12 in compliance with the senate
Rules and regulations Governing the conduct and Discipline of Maasai Mara University (7.
Academic Responsibility and Leadership),
MR/MISS/MRS………………………………………………..………………………….
(CAPITAL LETTERS) official registration names only)
Do hereby declare my intention to contest for the post of …………………………………………

Attached below is a list of my nominees in accordance with the constitution

SIGNATURE OF THE CANDIDATE…………………………………………………………………

NAME OF AGENT………………………………REG NO…………………….SIGNATURE: ………

 MMU/SAF/F05

MAASAI MARA UNIVERSITY

MMUSA ELECTIONS
CLEARANCE FORM FOR MMUSA SC
NAME:…………………………………… REG. NO………………………………………

POSITION…………………………………………………

Dear Sir/Madam
COMPLIANCE CERTIFICATE
I …………………………………wish to present myself for the post of ………………………

4. CERTIFICATION BY: REGISTRAR ACADEMIC AFFAIRS…………….……………………

I wish to certify that Mr. /Mrs. ……………………………has shown consistent and his/her
performance is 60% or above and I certify that his/her class work will not suffer by offering
him/herself for the post of a SGC

NAME: _____________________SIGNATURE_______________ DATE/STAMP

5. CERTIFICATION BY : FINANCE OFFICE

I Certify that the above named have no outstanding fee balances for the previous academic years
and has paid 60% of the current semester.

NAME: __________________ SIGNATURE: ________________ DATE/STAMP

6. CERTIFICATION BY : SENIOR SECURITY OFFICER

I Certify that the above named have no criminal record or any continuing investigation

NAME: __________________ SIGNATURE: ________________ DATE/STAMP

DECLARATION
Having read and understand that MMUSA Constitution Article 12 in compliance with the senate
Rules and regulations Governing the conduct and Discipline of Maasai Mara University (7.
Academic Responsibility and Leadership),
MR/MISS/MRS………………………………………………..………………………….
(CAPITAL LETTERS) official registration names only)
Do hereby declare my intention to contest for the post of …………………………………………

Attached below is a list of my nominees in accordance with the constitution

SIGNATURE OF THE CANDIDATE…………………………………………………………………

NAME OF AGENT………………………………REG NO…………………….SIGNATURE: ………

 MMU/SAF/05

MAASAI MARA UNIVERSITY

NOMINATION FORM
FOR MMUSA ELECTIONS- 2022/2023
S/NO. NAME REG.NO SIGNATURE DATE
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.
32.
33.
 34.
35.
36.
37.
38.
39.
40.
41.
42.
43.
44.
45.
46.
47.
48.
49.
50.
51.
52.
53.
54.
55.
56.
57.
58.
59.
60.
61.
62.
63.
64.
65.
66.
67.
68.
69.
70.
71.
72.
73.
74.
75.

DATE:--------------------------------------- TOTAL APPROVED ………………………………………….

DEAN OF STUDENTS