Surname: SHIFAH

Other names: MARIAM

Sex: FEMALE

Class: TOP CLASS

Date of birth: 23^rd/NOV/2012

Telephone No: 0755 405 733

Residential address: MASSAJJA

RECOMMENDER: I certify that the applicant is personally known to me and to the best  my knowledge and belief, facts stated on this form are correct. I am a citizen of Uganda.

Full names:  NAMIIRO ZAINAH

Address: MASSAJJA                                                               signature………………………………

BASIC AIDS ORGANISATION:

We as the organization we agreed with this information obtained here for any assistance rendered

THANK YOU MAY GOD BLESS YOU