STUDENT REQUEST FORM
NAME: ANDREW MCKENZIE ADM.NO: BEDK/2/00182/3/21 PROGRAMME: Bachelor of
Education arts STAGE OF STUDY: Year 4 SEMESTER: 4.1 EMAIL ADDRESS:
[email protected] TEL: 0702286713 DATE :15/09/2025
A. I hereby request (tick relevant one and specify the period in the space provided)
1. Academic leave (Trimester Deferment)
2. Deferment of Examinations (Fill Table 1 Below)
3. Transfer (Programme to programme)
4. Dropping/ Adding a course(s) (Fill Table 1 Below)
(Specify duration for 1and 2 above).............................................................................................
(Specify programmes for 3 above) FROM ……………….. TO ……………………………….
COURSE DROPPED/EXAM COURSE ADDED SESSION
COURSE/S DEFERED
1 Enterprenuership in Education(registered Population geography( GEO416)
twice)
2
3
4
5
6
7
8
B. Give specific reasons for your request (Please tick appropriately)
Financial Medical (Attach medical documents) Compassionate
Others (Specify)
Unregistered unit
………………………………………………………………………………………………………
Student’s Signature: Date: 15/09/2025
FOR OFFICIAL USE ONLY
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C. To be filled in by the Dean of School
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a) Does the Dean of the School approve of this request? Please give detailed comments.
.………………………………………………………………………………………………………………
…………………………………………………………………………………………………………
Name: ……………………………………………. School: ……………………………………………
Signature and official stamp ………………………………….
D. To be filled by Director/ Dean of School/ Department/ to which student requests transfer
Please indicate availability of vacancy in your department in the intake or course requested.
AVAILABLE NOT AVAILABLE OTHERS (Specify):
..............................................................................................................................................................
Name: ……………………………………………. School: ……………………………………………
Signature and official stamp ………………………………….
E. Finance/ Accounts Department
Fee balance
Comments……………………………………………………………………………………………….……
…………………………………………………………………………………………………………………
……………………………………………………………………………………
................................................. …………………….
Signature Date
Chief Finance Officer
F. Registrar’s comment
ACCEPT REJECT
Name: ……………………………………………. Date: ……………………………………………
……………………………….
Signature
Registrar (ASA)
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