testdate – Enabling Girls in AI and Growing Expertise (ENGAGE) in Data Science

Are you willing to participate? *YESNO

Full Name of Applicant:

Student Admission Number

Date of Birth (DD/MM/YYYY):

Home Physical Address

County of Residence

Sub-County of Residence

Ward

Location

Sub-Location

CitizenshipAre you a Kenyan Citizen?”YESNO

SexWhat is your gender?MaleFemaleOther

Age

Attach copy of birth certificate

No file chosen

Which is the nearest public primary school to your home?

SECTION B: Academic Background

Secondary SchoolList of Documents to attach in this section: copies of; First Term 2025 Results (Stamped), 2024 Results (Stamped)

Name of current school

School postal address

County the school is located

Sub-County

Ward

Location

Sub-Location

What class are you in?(Only Form 3 students are eligible)

First Term 2025 Exam Grade

Math Grade - Term 1, 2025

Are you a member of any club or society?YESNO

If Yes, state

Name of Headteacher

Phone Number of Headteacher

First Term 2025 Results (Stamped)

No file chosen

2024 Results (Stamped)

No file chosen

Primary School

Name of Primary School attended

Primary School postal address

County of Primary School

Headteacher Phone

KCPE Marks

List of Awards/Recognitions Received

SECTION C: Leadership and Commitment

Leadership and Commitment

Have you held any leadership roles?YESNO

If yes, describe

What motivates you to apply for the ENGAGE Project training?

Will you be available to attend a 10-day residential training, (November 24th to December 5th 2025)?YESNO

SECTION D: Financial & Family Background

Number of people living in your household

Number of Dependents Under 18 (or Over 18 in School)

Number of elderly members in your household (65+ years):

Number of members with disabilities: (Specify)

Do you have any disability or special needs?YESNO

Provide details here

Are you currently receiving any bursary,scholarship or any benefit from church/community/partner?YES(since primary)YES(only secondary)NO

If yes, state the name of the sponsor/Church/community/partner supporting you:

Select Sponsor

Do you have any siblings who are currently employed /working?YESNO

If yes, describe the work they do:

Details of work done by siblings here

Do you experience difficulties meeting basic needs at home?YESNO

If yes, explain

Experience difficulties

Have you ever been sent home due to lack of school fees while in high school?YESNO

If yes, explain

If Other Explain

Does your family own any land?YESNO

If yes

size in acres

Are you receiving bursary, scholarship or community support?YESNO

If yes

List the Source(s)

SECTION E: Referrals and Verification

Other specify

Provide a name of a Referee and their contact (teacher, pastor, etc.) – a person who knows you and your home:

Are you willing to be contacted for verification?YESNO

If yes, explain

Preferred phone number

Select the University that falls within the region where your current secondary school is locatedJaramogi Oginga Odinga University of Science and Technology (JOOUST)Kabarak UniversityDedan Kimathi University of Science and Technology(DEKUT)Meru University of Science Technology (MUST)South Eastern Kenya University (SEKU)Pwani University

Indicate if you have any special need that should to be considered if selected for this training project? (Please specify)

SECTION F: Declaration

List of documents required in this section: Upload Duly filled Consent Form

Upload Duly filled Consent Form

No file chosen

Feedback about the application experience

I declare that the information provided above is true and accurate to the best of my knowledge.

Save as Draft