Practical Exam Registration Form

First Name

Surname

Name on Certificate

Learner Email Address

Date of Birth

Gender

Instrument

Grade

Left or Right Handed

Session Date

Bringing Own Kit

Translator Required

Preferred Exam Centre

Reasonable Adjustment Description

Presented By

Payee First Name

Payee Surname

Payee Email Address

Payee Centre

Payment Method

M-Pesa Code

Additional Notes

Payment Details

ACCOUNT NAME: ELNELI SCHOOL OF MUSIC LIMITED;

BANK NAME: KCB BANK KENYA LTD

ACCOUNT NUMBER : 1286897467

BRANCH NAME: SARIT CENTRE

BANK CODE: 01

BRANCH CODE: 141

SWIFT CODE: KCBLKENX

M-PESA

PayBill No: 522522

Acc: 1286897467

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