RWANDA EDUCATION BOARD
P.O Box 3817 Kigali
Telephone : (+250) 255121482
E-mail: [email protected]
Website: www.reb.rw
Attach a recent
passport size photo
USE GLUE ONLY
DON’T USE STAPLES
NATIONAL EXAMINATIONS, 2016
REGISTRATION FORM FOR ORDINARY LEVEL CANDIDATES
Instructions :
1. This form must be filled in two original copies.
2. The headteacher must sure that details filled in ALL SECTIONS of this form are complete and accurate before signing.
SECTIONA: CANDIDATE IDENTIFICATION
1. Full index number of candidate:
Province/City District
Student’s number
School
O L C
2.Surname (Nom)……………………………………………………..…Other names (Prénom)……………………………………
3. Sex (F or M)
4. Year of birth
4. Candidate’s signature …………………….………….
SECTIONB: SCHOOL IDENTIFICATION
1. Name of current school: ……………..……….. ……………..………...………District……………………………………..
2. Head teacher’s name.………………………………………..………..…...Phone number..….....…………..…………………
SECTION C: PARENTS IDENTIFICATION
1. Father’s surname (Nom)…………………………………………… …..Other names (Prénom)…………..……..…………..……
2. Mother’s surname (Nom)……………………………………………… Other names (Prénom)………………...…………..…
3. *Guardian’s surname (Nom)………………...………………………….. Other names Prénom)……..……………………….…
4. Parents’/Gardian’s residence: District: ………………….…………..Sector: …………………………. Cell.………………...…
SECTION D: SCHOOL CHOICE
- On choice No: rank them according to your preference (eg: If your choice No 1 is TVET, write 1under TVET; if your choice No 2 is General Education write 2 under
General education). Do not make more than two choices
UR/College of Education
General
Education
Choice No: ……..
Combination
…………
School code:……………………
Teacher Education
TVET
Choice No:……..
Trade
…………
Choice No: ……..
TSS code:…………….…………..…
Option
…………
TTC code:……………………..…
E. SPECIAL NEEDS (Tick the right box):
1. Physical Disabilities
2. Sensory disabilities
3. Other disabilities or Difficulties
a) Wheel chair user
b) Locomotional difficulties
a) Profound hearing difficulties
b) Mild hearing difficulties
a) Severe chronic Illness
b) Moderate chronic illness
c) Fine motor difficulties
c) Profound visual difficulties
c)Mild chronic illness
d) Other physical disabilities
d) Mild visual difficulties
d) Do you have medical documents?
Date of registration: …… /……/2016
Headmaster’s Signature ………………….….…...
Note: - Attach school reports for S1 and S2
*A guardian is a person who is not the biological parent but responsible for the candidates on behalf of parents
School
stamp