Naalya Secondary Schools S.5 Application form Academic year 2021/2022

Naalya Secondary Schools Application Form S.5 - 2021/22

For all campuses i.e. Lugazi, Bweyogerere and Namugongo.

Student's Personal Details

Details of the Student applying.

First Name

Middle Name

Last Name

Gender

Female

Male

Date of Birth (DD/MM/YYYY)

Place of Birth (City, Country)

Nationality

Home Address

Address Line 1

Address Line 2

City

Country

Campus

Requested Academic year

Requested Class of Entry

Last school Attended

Last School Attended Address

Address Line 1

City

Country

UNEB Number and Uganda Certificate of Education (UCE)/ O-Level Results

Selection of Choices

Select at most 4 combinations from most to least preferred.
Exceeding 4 selections will not be considered.
Select choices corresponding to the matching campus.
Other selections will be considered as second or third choice.

NB: Read the instructions before proceeding.

Lugazi Choices/Combinations

Bweyogerere Choices/Combinations

Namugongo Choices/Combinations

Parent/ Guardian Details

Details of the Parent or Guardian for the applicant.

Parent/Guardian 1 First Name

Middle Name

Last Name

Relationship to Student

Nationality

Home Address (Same as student? If no, please specify below)

Parent Home Address

Address Line 1

City

Country

Parent/ Guardian Mobile Number

Occupation

Parent/Guardian 2 First Name

Middle Name

Last Name

Relationship

Nationality

Address

Address Line 1

City

Country

Mobile Number

Occupation

Emergency Contact Person

Next of Kin

Emergency Contact Person First Name

Last Name

Relationship

Mobile Number

HEALTH HISTORY

Please give the student's health history.

Mention If the student has any allergies, please specify below:

Is the student currently taking any medication? If yes, please specify below:

Has the student been hospitalized for any type of surgery in the previous six months? If yes specify below:

Immunization/Vaccination

Payment Section

Mobile payment method is applicable for the application Form (i.e. MTN and Airtel UGX 20,000/=). Include transaction fee respectively. For other forms of payment, please contact the school on the direct line at this link. Please pay to the Respective campus Mobile Contacts provided below.

Lugazi Campus Application Form Payment

e.g. MTN or Airtel , Include mobile transaction ID Number

MTN +256786416785

Make payment on this Naalya Mobile Number.

Airtel +256755924633

Make payment on this Naalya Mobile Number

Mobile Money Transaction ID Number

Bweyogerere Campus Application Form Payment

e.g. MTN or Airtel , Include mobile transaction ID Number

MTN +256786116543

Make payment on this Naalya Mobile Number.

Airtel +256755924668

Make payment on this Naalya Mobile Number.

Mobile Money Transaction ID Number

Namugongo Campus Application Form Payment

e.g. MTN or Airtel , Include mobile transaction ID Number

MTN +256778557712

Make payment on this Naalya Mobile Number

Airtel +256755924669

Make payment on this Naalya Mobile Number

Mobile Money Transaction ID Number

Upload Receipts

Whatsup Number +256786416796

I have read and Agree to the Terms and Conditions. I certify that all information in this application form is credible and accurate.