Surname:    MIREMBE

Other names:  SHILLAR

Sex:  FEMALE

Class:  PRIMARY FIVE

Date of birth: 2003 (13YRS)

Telephone No:  0759813321

Residential address:  MASSAJJA

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

Full names:   NAKITTO FLORENCE

Address: MASSAJJA                                                                  Signature

BASIC AIDS ORGANISATION

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

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THANK YOU MAY GOD BLESS YOU

Name of the school: MD DAY BOARDING PRIMARY SCHOOL

Boarding Requirements:  admission fees (UGX 10000), ream, fees (UGX 450000), school uniform (UGX 149000), files, books, covers, toilet paper, brooms and clear bag.