Surname: NAMUTEBI

Other names: SHIFRAH

Sex: FEMALE

Class: PRIMARY FIVE

Date of birth:

Telephone No: 0755 255 222

Residential address: Ndiktutamada-Massajja

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

Full names : NANKYA  ANGEL

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