East Africa Institute Of
    Professional Counseling.

      email: info@eaipc.ac.ke

APPLICATION FOR TRAINING


Complete this application form and send it to: Director of Training, P.O. Box 4770-00200, Nairobi. This application form is issued after payment of non-refundable, non- creditable application fee of Ksh 1,000 (One Thousand Shillings only) made payable to: East Africa Institute of Professional Counseling.

SECTION 1: Course Information (Please print in capital letters)

* For a Diploma:
* For a certificate:
* For a short course:




SECTION 2: PERSONAL DATA OF APPLICANT (Please print in capital letters)

*

*
*
*
*
*

Next of KIN
*
*

* (Specifiy relationship with next of kin indicated above e.g. parent, brother, spouse, friend, in-law, cousin, etc.)
* Your Date of Birth

Male Female Prefer not to say


SECTION 3: ACADEMIC PROFILE (Please print in capital letters)

*
*
* From Year
* To Year
*


From Year
To Year



From Year
To Year



From Year
To Year








  Contact Us

    0721 201 564
    0708 117 760
    info@eaipc.ac.ke

  Visit Us

    3rd floor, Summit House
    Moi Avenue
    Nairobi

  Postal Address

    4770 - 00200
    Nairobi
    Kenya




Copyright © 2019 Design: Abraham Mutea