St. Joseph's Ss Namugongo

First Name *

Last Name *

Email *

Sex*

Date Of Birth *

Age *

Date of entry *

Nationality *

Religious Affiliation*

Class *

Combination (for ‘A’ Level) *

Arts/Science*

Resident or non resident*

Section *

Student’s Educational Background.

Name of Previous school *

Year of PLE *

Aggregate *

Result/Grade *

Name of Secondary school attended (if any)

Year of UCE

Aggregate1

Result/Grade1

Parent’s/Guardian’s information

Parent’s/Guardian’s full name *

Physical Address *

Place of work *

Profession *

Occupation *

Tel. contacts (For Father/Guardian) *

(For Mother/Guardian) *

Nationality of Father/Guardian *

of Mother/Guardian *

Person to contact in case of Emergencies *

Physical Address1 *

Place Of Work1 *

Contacts *

Parents residing abroad are kindly requested to give a name and address of a guardian in Uganda authorized to act on their behalf.

Name (in Full) *

Physical Address2 *

Contacts1 *

NOTE:

Attach a Photocopy of previous report Card/recommendation/Pass slip to this application

I declare that the information given on this form is true

Signed Date*

Student*

Signed Date1*

Parent*

Cross-checked Date*

(Head Teacher)*

Level *

Password *

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Student’s Educational Background.

Parent’s/Guardian’s information

Parents residing abroad are kindly requested to give a name and address of a guardian in Uganda authorized to act on their behalf.

NOTE: