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Enrollment Application for Mental Health
Personal Information
Full name:
Email:
Phone:
Gender:
Male
Female
Other
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Date of birth:
Education Background
Highest qualification:
Education background:
School Name, Grades, Final Year Attended
Next of Kin
Next of kin name:
Next of kin relationship:
Next of kin contact:
Identity & Disability Status
Identity type:
National ID
Passport
Identity number:
Disability status:
None
Physical
Visual
Hearing
Other
Disability details:
Document Uploads
Accepted: PDF, JPG, PNG. Required: Identity Doc. For Diplomas: Secondary Results.
Identity_document:
Secondary_results:
Course & Message
Course:
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Social Work
Psychosocial Counselling
Certified Assistant Nursing
Nursing Assistant
Parliative Care
HIV Management
Trainer of Trainees
Business Management
Business Administration
Human Resource Management
Cattle & Fish Farming
Laboratory Safety
Sales and Marketing
General Agriculture
Occupational Health and Safety
Agribusiness
Public Relations
Information and Communication Technology (ICT)
Computer Science
Information Technology
Community Development
Project Management
Primary Teaching
Secondary Teaching
HIV /AIDS Management
Certified Nursing Assistant
Mental Health
Clinical-counseling
Clinical -counseling
Psychosocial counseling
Stores and warehouse management
Message:
Submit Application