Surname: NJAGALA

Other names:  BALAKA

Sex: MALE

Class: SENIOR ONE

Date of birth: 16^TH/06/2002

Telephone No: O755 230 631

Residential address:    MASAJJA

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: NASIWA NOELINE

Address: MASAJJA                                                                     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

REASONS: I am humbly requesting for assistance due to poverty which will leave us as school dropouts.

My dad passed away years ago and my mother is working so hard to take care of us but the money she gets is not enough to take care for us .we will be very grateful for your assistance may God bless you.