Step 1 of 7 14% Personal detailsName(Required) First Middle Surname Gender(Required) Male Female Choose not to identify What is your national ID card number?(Required)Date of birth(Required) MM slash DD slash YYYY What is your current relationship status?(Required) Single Married In a relationship Widowed Divorced Prefer not to answer What local language (besides English and Swahili) do you speak?(Required)—select—AmeruBajuniBukusuChonyiDigoDurumaElgeyoEmbuGiryamaIsukhaJibanaKalenjinKambaKambeKaumaKikuyuKipsigisKisiiKoreKuriaLuhyaLuoMaasaiMaragoliMarketMiji KenyaNandiOgiekOrmaOromoPokomoPocketRabaiRendilleRibeSabaotSamburuSingerSomaliSubaTachoniTaitaTavetaTerikTugenTurkanaYaakiPrefer not to answerOtherOnly English and/or Swahili Contact informationPlease enter the address of your primary residence(Required)Mobile number(Required)Numbers only pleaseHome phone number (optional)Numbers only pleaseEmail address (optional) Emergency contactsPlease provide the name and contact information for people who would know how to find you. Please give the names and contact information of the person most likely to know how to reach you. Contact person (1) - Name(Required)Contact person (1) - Relationship to you(Required)—select—FatherMotherUncleAuntBrotherSisterOtherContact person (1) - Phone number(Required)Numbers only pleaseContact person (2) - Name(Required)Contact person (2) - Relationship to you(Required)—select—FatherMotherUncleAuntBrotherSisterOtherContact person (2) - Phone number(Required)Numbers only please HouseholdAre you a single parent? Yes No Prefer not to answer How many children do you have?(Required)012345678910 or morePrefer not to answerHow many people are you financially supporting?(Required)(e.g., children, parents, siblings)012345678910 or morePrefer not to answerOf the people you are financially supporting, how many of them are your children?012345678910 or morePrefer not to answerOf all your immediate family expenses (e.g., rent, food, healthcare, education), how much do you contribute?(Required) None Less than half More than half I am the sole breadwinner/main contributor Which of the following statements best describe your current financial situation. Would you say:(Required) I don't have enough for daily needs and am currently receiving financial assistance from family / friends I sometimes don't have enough for daily needs I have just enough for daily needs I am able to save some money Which is your primary source of financial assistance?(Required) Family Friends Other Schooling and trainingWhat is the highest level of education you have achieved?(Required) Completed a bachelor's degree Completed two year diploma or associate degree Completed vocational training certificate or other credential Some vocational training beyond High School (no certificate or credential achieved) Some college / higher education High School or KCSE Haven't finished high school What was your field of further study? (If any education beyond high school)—select—Commerce/FinanceHumanitiesSocial StudiesMedicineEngineeringPhysical ScienceLawRetail/Customer ServiceITManufacturingEducationAgricultureOtherWhat was your overall KCSE grade?(Required)AA-B+BB-C+CC-D+DD-EYAre you currently studying?(Required) Not currently studying Studying part-time (less than 5 hours per day) Studying full-time (more than 5 hours per day) EmploymentHave you ever had a paid job?(Required)(includes working at a your own / family business) Have never been employed Have only been employed part-time Have been employed full-time Total length of work experience(Required)—select—0-3 months4-6 months7-11 months1-3 yearsMore than three yearsIf you have been or are currently employed, what was your monthly income before taxes?(Required)(including salary and average commission/business earnings, if any)—select—01-5,000 KES5,001-10,000 KES10,001-15,000 KES15,000 KES & aboveAre you currently working at a paid job?(Required)(includes working at a your own / family business)—select—Not currently workingWorking part-time (less than 40 hours per week)Working full-time (40+ hours per week)How long have you been unemployed?(Required)—select—0-1 month2-3 months4-6 months7-12 monthsMore than 1 yearHow long have you been looking for a job?(Required)—select—0-1 month2-3 months4-6 months7-12 monthsMore than 1 year Additional informationCan you drive?(Required) Yes and I have a driving licence Yes but I do not have a driving licence No I cannot drive Are you planning on joining a College or University to study?(Required) Yes No How many months from now will you be going to study?(Required)—select—3 months6 months12 monthsNot sureHow did you hear about the program?(Required)—select—A friend or a family memberAn alumniMy schoolCommunity MobilizerA government initiativeEmailPhone callJob fairFacebook / Twitter / Other Social mediaMentorWebsiteOnline job portalGeneration Flyer / Other Promotional materialsText message / WhatsAppRadio / NewspaperTraining CenterOther AcknowledgementI acknowledge that the information I have provided in this application form is accurate to the best of my knowledge.(Required) Yes Date(Required) MM slash DD slash YYYY If your application is successful, you will need to supply (1) a copy of your national ID, (2) a copy of your KCSE certificate and (3) a letter of support from a reference (e.g., parent, guardian, former teacher, church leader).(Required) I understand the above If your application is successful, you will need to pay KES 3,000 by the end of Day 1 of the training program.(Required)Should this be a concern, please discuss the installments option with our team at the center that you are applying to. I understand the above CAPTCHANameThis field is for validation purposes and should be left unchanged.
