1) Applicant Information

First Name*
Middle Name
Last Name*

Date of Birth*
Gender* FemaleMalePrefer not to sayOther
Nationality*

National ID / Passport Number*
Passport Photo*

Email*
Mobile Phone*
Alternate Phone

County (Auto-filled: Bungoma)*
Town / City*
Postal Address

2) Academic Background

Highest Qualification* KCPEKCSECertificateDiplomaOther

School / Institution
Year Completed

KCPE Marks (if applicable)
KCSE or Higher Mean Grade AA-B+BB-C+CC-D+DD-E

3) Programme Selection

Programme Level* DiplomaCertificate

Diploma Courses:
—Please choose an option—CosmetologyHairdressingBeauty Therapy

Certificate Courses:
—Please choose an option—HairdressingBeauty TherapyNail TechnologyMakeup ArtistryBarberingComputer Packages

Study Mode* Full-timePart-time
Preferred Intake (Monthly)* JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember
Preferred Campus

Hostel Plan I would like to apply for hostel accommodation

Hostel details will be communicated later.

4) Parent/Guardian / Emergency Contact (Optional)

Guardian Full Name
Relationship
Phone
Email
Address

5) Supporting Documents

National ID/Passport Upload*
Education Certificates Upload*
Other Relevant Certificates

6) Declaration & Consent

I declare that the information provided is true and complete.
I consent to Deeva Beauty College processing my personal data for admission purposes (Kenya Data Protection Act, 2019).