ELB ACT (1995) CAP213A
HIGHER EDUCATION LOANS BOARD
UNDERGRADUATE FIRST TIME LOAN APPLICATION FORM DIRECT
ENTRY-GOVERNMENT/SELF SPONSORED AND PRIVATE UNIVERSITIES
2020/2021
CAUTION
Any person or student who when filling an application form, knowingly makes a false statement whether orally or in writing relating to any matter affecting the
application shall be guilty of an offence and shall be liable to a fine of not less than Kenya Shillings Thirty thousand (Ksh. 30,000) or to imprisonment for a
term of not less than three years (Section 13 (3) of the Higher Education Loan Board Act (CAP 213A)).
APPLICANT'S PERSONAL DETAILS- APPLICANT
First Name Middle Name Last Name
ID/No.(attach copy) KRA PIN Date of Birth Gender
Email Mobile No. Address Physically / Visually Challenged?
County Constituency Ward
APPLICANT'S CURRENT PLACE OF RESIDENCE
Nearest Public Primary Estate/Village Sub-location Location
County Constituency Ward
Institution Details
(Attach copy of Admission Letter-Mandatory)
Level of Study Institution Name Faculty/School
Admission/Registration No. Year of Admission Current year of Study Year of Completion
Admission Category Course
Private Self Sponsored
Loan (Per Annum)
Amount applied for? Amount your family can raise towards your fees?
xxxxxxx xxxxxxxxx
Education Background (**Attach evidence for post primary schooling)
Exam Grade &
Level Institution Name Year Index Number Inst. Type Country Points
PRIMARY Kenya
SECONDARY Kenya
DETAILS OF PARENTS
FATHER
First Name Middle Name Other Name ID No. NHIF Deduction Rate.
xxxxxxxxx
Highest Level of Mobile/Telephone
Education
Year of Birth
XXXXXXX
KRA PIN Employed Occupation/Profession
xxxxxxxxx
Employer Name Employer Tel. no. Staff no.
MOTHER
First Name Middle Name Other Name ID No. NHIF Deduction Rate.
xxxxxxxxx
GUARANTORS
Guarantor 1
SURNAME FIRST NAME OTHER NAME
ID No.
Tel No # Box No # Post Code
Town Email County
Constituency Ward
Location Sub-Location Year of Birth XX
Employer Name Employer Tel. No. Employer Email XXX
Employer Postal Employer
Employee No Address NULL Postal Code XXX
(also known as "the guarantor" hereby) acknowledge that I am bound to the Higher Education Loans Board in the sum of amount equivalent to what
the Board shall grant to ------------------------------------------------------as loan under the agreements together with interest thereon, which amount I
shall repay to the Higher Education Loans Board in the event that the loanee fails to honor his/her obligation of repaying the same to the Board as
from the prescribed time. The loanee will notify me of the amount granted to the him/her after the award is made. This bond is conditioned to be
void only after full repayment by the loanee is
Guarantor 1 Signature and Date Advocate/ Magistrate Signature, Date , Official Stamp
GUARANTORS
Guarantor 2
SURNAME FIRST NAME OTHER NAME
of ID No.
Tel No # Box No # Post Code
Town Email County
Constituency Ward
Location Sub-Location Year of Birth xx
Employer Name Employer Tel. No. Employer Email xx
Employer Postal Employer
Employee No Address XXX Postal Code XXXX
(also known as "the guarantor" hereby) acknowledge that I am bound to the Higher Education Loans Board in the sum of amount equivalent to what
the Board shall grant to ------------------------------------------------------as loan under the agreements together with interest thereon, which amount I
shall repay to the Higher Education Loans Board in the event that the loanee fails to honor his/her obligation of repaying the same to the Board as
from the prescribed time. The loanee will notify me of the amount granted to the him/her after the award is made. This bond is conditioned to be
void only after full repayment by the loanee is
Guarantor 1 Signature and Date Advocate/ Magistrate Signature, Date , Official Stamp
BANK DETAILS
Bank Name:……………………………………………………………….
Branch Name :…………………………………………………………….
Account Number :………………………………………………………..
