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    Single Parent Self Certification 2024

    Uploaded by

    cgughjpseph

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Single Parent Self Certification 2024

    Uploaded by

    cgughjpseph
    7 views1 page

    Copyright

    © © All Rights Reserved

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    PDF, TXT or read online from Scribd

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    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    7 views1 page

    Single Parent Self Certification 2024

    Uploaded by

    cgughjpseph

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    You are on page 1of 1

    Single Parent Self-Certification

    1. Student Details

    Student Name
    National ID number University/College
    KCSE Index Number Admission Number
    Telephone Number E-Mail Address

    2. Parents details

    Parent’s Full Name


    National ID number
    Telephone Number
    Relationship with the applicant/student Mother  Father 
    Current Marital Status Single  Separated  Divorce 

    3. Declaration by the parent


    I declare that;
    • That I am the biological parent of the applicant/student mentioned in one (1) above.
    • That the applicant/student mentioned in one (1) above has been under my exclusive and single
    parental care and custody.
    • That being a single parent, I have been providing for the applicant/student needs and have given
    his/her financial and emotional support.
    • That the information provided in this certification is true and accurate to the best of my
    knowledge. I understand that any false information may result in the rejection of the application
    or withdrawal of any awarded funding.
    • That I am conversant with section 129[A] of the penal code CAP 63 Laws of Kenya and the
    consequences of providing false information or submitting a fake document to a government
    officer.

    Parents Name Signature Date

    4. Commissioner of oaths/Magistrate
    The above applicant and his/her parent
    appeared before me and made the solemn
    declaration that the information given
    herein is correct

    Signature and Date Official Stamp

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