Student Name *
Student Name
Gender *
Date of Birth *
Date of Birth
Language most frequently used at home
Please include school name, language used, curriculum and years attended.
Please include school name, curriculum and years attended.
Father's information
Mother's information
Medical Information
Is the student currently taking any medication on a regular basis?
Will the student need to take this medication while at school?
If yes, please provide the school with written instructions before first day of school.
Does the student have a history of previous medical concerns or surgery?
Does the student have any known allergies?
Include symptoms that student has experienced during an allergic reaction

The application fee is $20 or 45,000/=. You can send the fee by Mpesa or deposit into our bank account.

Mpesa +255 755 362 326 (Display Name: Caroline Epe)

Bank Account Information
Exim Bank
Account Name: Black Rhino Foundation Ltd.
TSH Account Number: 0120008330
USD Account Number: 0120008331

Please email us at with information on how you paid after you have submitted your application.