Application For Intership Programme Form Template - Public Service Commission printable pdf download

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…………………………………………………………………………………………………………………………………

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Application For Intership Programme Form Template - Public Service Commission