Name:

Age:

Student Information
Grade
Form 3
Medical Condition(s)
N/A
Previous Performance
Average.
School
Child’s performance and behaviour in school
Disciplined.
Name of the school
Ivaini Secondary
Parent/ Guardian Information
Name
Jackson Luka Omengo
Phone Number
0717091702
Physical Residence
Mahungu
Employment Status
N/A
Any other details
N/A
School
Child’s performance and behaviour in school
Disciplined.
Name of the school
Ivaini Secondary
Class teacher/ teacher in charge’s name and phone number
N/A

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