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KISEB Registration Form

The document is an application form for registration with the Kenya Institute of Supplies Management in partnership with KASNEB for professional and associate examinations. It includes sections for personal details, education level, payment details, and a declaration by the applicant. Additionally, it outlines the necessary supporting documents and registration fees for both local and foreign students.

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judywanzala484
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Download as PDF, TXT or read online on Scribd
46 views

KISEB Registration Form

The document is an application form for registration with the Kenya Institute of Supplies Management in partnership with KASNEB for professional and associate examinations. It includes sections for personal details, education level, payment details, and a declaration by the applicant. Additionally, it outlines the necessary supporting documents and registration fees for both local and foreign students.

Uploaded by

judywanzala484
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
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CPSP/APS/1

KENYA INSTITUTE OF SUPPLIES MANAGEMENT


in partnership with KASNEB

APPLICATION FOR REGISTRATION FORM

Kenya Institute of Supplies Examination Board, KISM Towers, 11th KASNEB Towers, Hospital Road, Upper Hill, P.O. Box 41362 – 00100
Floor, Ngong Road, P. O. Box 30400 – 00100 NAIROBI. +254726244828, Nairobi, Kenya Telephone: +254(020) 2712640/2712828 Cellphone: 0734
+2540769878228, +254733333226, +254721244828 Email: 600624/0722 201214 Fax: +254(020) 2712915 Email: [email protected]
[email protected]: Website: www.kiseb.or.ke Website: www.kasneb.or.ke

Before filling in this form, please read carefully the notes at the back of this form and the guide to
examinations.

Tick as appropriate
PROFESSIONAL EXAMINATIONS (CPSP): ASSOCIATE EXAMINATIONS (APS):
1. Personal details Examination Section(s)/Level
(a) Name

FIRST NAME MIDDLE NAME(S) SURNAME


(See note 1 and 2)
(b) Nationality ________________ (c) Date of Birth (d) Gender M F
(e) Contacts
Email _________________________Cellphone _______________ Landline________________
(f) Address
C/o __________________________ P.O. Box _________________ Code _____________ Town/City _____________
Country __________________
(g) Next of Kin/Guardian Details: Name ______________________________________________________________
ID. No. ___________________________ Mobile No. __________________________________
2. Level of Education (Academic/Professional)
___________________________________________________________________
(Attach certified copies of certificates as per note 3)

3. How did you learn about APS/CPSP exam?


Career Talks Media Student
Sponsor Guardian Parent Friend Others ___________
4. Payment details
I enclose Cash/Cheque/Money-Order/Bank Deposit slip, MPESA reference No. _____________ for Sh.
______________ in respect of registration fee. Return filled forms and all supporting documents to KISM
offices at Nairobi - you may hand-deliver, send by courier or through your training institution.
Standard Chartered Bank, Westlands, Account No. 0102096929100;
MPESA PAYBILL No. 552500.

5. Declaration by the applicant


I hereby certify that to the best of my knowledge that all the information I have provided in this form is true
and correct and I agree to abide by the Examination Rules and Regulations of KISM and KASNEB.

PASTE YOUR
Signature_____________ Identity Card No.______________ Date__________
COLOUR
PASSPORT SIZE
PHOTOGRAPH
HERE
Rev. 0/2014
CPSP/APS/1

FOR OFFICIAL USE ONLY

Receipt No. ________________


Amount Sh. ________________
Signature ________________
Date ________________
First exam date ________________
First renewal date ________________

NOTES
1. Complete the form in CAPITAL LETTERS (in black or blue ink).
2. (a) Print your name in full in the order on No. 1 (a) of this form.
(b) Change of name must be supported by a legal document (such as Marriage certificate,
Affidavit or Deed poll).
3. Indicate your identity card/Passport No. /Identity card waiting slip No. or Birth certificate No.
(for those under 18 years) on the space provided; enclose a passport size photograph,
identification document and CERTIFIED copies of your certificates. The documents must be
certified by your employer/referee or by any person specified here below;
 Registrars of colleges, institutions or universities.
 Licensed Practitioners of KISM (must quote their registration number).
 A senior civil servant (such as Education Officer, School Principal. District Officer,
Magistrate or an Officer of higher ranking).
 Commissioner of oaths.
 The Clerk or Senior Officer of any Local Authority, or a Senior Officer in a State Corporation
or organization.
 In exceptional circumstances, Chiefs, Assistant Chiefs, Primary School Head Teachers and
religious leaders.
All copies of certificates must be certified, signed and rubber stamped by the same person.
4. KISM reserves the right to confirm the certified copies of certificates.
5. Please ensure that your application for registration form is duly completed before payment of
fees.
6. Any application for registration form which is not accompanied by supporting documents and
the correct fee will be rejected.
7. Personal cheques will not be accepted.
8. Abbreviations
CPSP - Certified Procurement and Supply Professional
APS - Associate in Procurement and Supply

Student Registration deadlines


May examinations November examinations
31 March 30 September
STUDENTS REGISTRATION FEES
Kenya Foreign Currency
EXAMINATIONS Kshs US$ £Sterling

PROFESSIONAL EXAMINATIONS 5,500


ASSOCIATE EXAMINATIONS 5,000

Rev. 0/2014

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