"Application for Internship Programme Form" - Kenya

This Kenya-specific "Application for Internship Programme Form" is a document released by the Kenya Public Service Commission.

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REPUBLIC OF KENYA
PUBLIC SERVICE COMMISSION
APPLICATION FOR INTERNSHIP PROGRAMME FORM
Please complete this form in BLOCK LETTERS and submit to the Ministry /
State/Department/Agency
that has advertised internship opportunities.
1. Ministry /Department/Agency…………………………………………………………………………..
2. Full name……………………………………………………………………………………………………………
3. Date of Birth……………………………………………………………………………………………………….
4. Gender………………………………………………………………………………………………………………..
5. Identity Card Number……………………………………………………………………………………….
6. Personal Identification Number (PIN)……………………………………………………………..
7. Certificate of good conduct……………………………………………………………………………...
8. Postal Address ……………………………Postal code…………………….Town……………………
9. E-mail Address…………………………………………………………………………………………………..
10. Mobile Number………………………………………………………………………………………………..
11. Home County………………………………………Sub- county…………………………………………
12. Ethnicity……………………………………………………………………………………………………………
13. Disability
Status……………………………………………………………………………………………………………….
14. Educational /Professional Qualifications
Examination…………………………………………………………………………………………………………………
University/Institution ………………………………………………………………………………………………..
Year of Graduation……………………………………………………………………………………………………..
Class/ Grades……………………………………………………………………………………………………………..
15. Area of Interest ………………………………………………………………………………………………….. .
I certify that the above information is true to the best of my knowledge
Name…………………………………………………………………………………………………………………………………
Signature…………………………………………………………………………………………………………………………
Date…………………………………………………………………………………………………………………………………
Page 1 of 1
REPUBLIC OF KENYA
PUBLIC SERVICE COMMISSION
APPLICATION FOR INTERNSHIP PROGRAMME FORM
Please complete this form in BLOCK LETTERS and submit to the Ministry /
State/Department/Agency
that has advertised internship opportunities.
1. Ministry /Department/Agency…………………………………………………………………………..
2. Full name……………………………………………………………………………………………………………
3. Date of Birth……………………………………………………………………………………………………….
4. Gender………………………………………………………………………………………………………………..
5. Identity Card Number……………………………………………………………………………………….
6. Personal Identification Number (PIN)……………………………………………………………..
7. Certificate of good conduct……………………………………………………………………………...
8. Postal Address ……………………………Postal code…………………….Town……………………
9. E-mail Address…………………………………………………………………………………………………..
10. Mobile Number………………………………………………………………………………………………..
11. Home County………………………………………Sub- county…………………………………………
12. Ethnicity……………………………………………………………………………………………………………
13. Disability
Status……………………………………………………………………………………………………………….
14. Educational /Professional Qualifications
Examination…………………………………………………………………………………………………………………
University/Institution ………………………………………………………………………………………………..
Year of Graduation……………………………………………………………………………………………………..
Class/ Grades……………………………………………………………………………………………………………..
15. Area of Interest ………………………………………………………………………………………………….. .
I certify that the above information is true to the best of my knowledge
Name…………………………………………………………………………………………………………………………………
Signature…………………………………………………………………………………………………………………………
Date…………………………………………………………………………………………………………………………………
Page 1 of 1