Full Name of Parent / Guardian:
Email Address of Parent / Guardian:
Full Name of Student Applicant:
Email Address of Student Applicant:
Students LRN (Learner's Reference Number): 12
Please ensure that scanned documents are CLEAR and LEGIBLE.. (allowed file types for uploads are .jpg, .jpeg, .png, .pdf, .gif)
Level applied for: Grade 11Grade 12
Strand applied for: STEMABMGASHUMMS
Report Card (Form 138) Front:
Report Card (Form 138) Back:
SHS Voucher(Optional):
Preferred Mode of Payment: Reservation