TEACHERS SERVICE COMMISSION

Telephone: Nairobi 2892000 0722208552/0777208552 Email: [email protected] Website: www.tsc.go.ke

TSC HOUSE KILIMANJARO ROAD UPPER HILL PRIVATE BAG NAIROBI, KENYA

 

TEACHERS NEXT-OF-KIN FORM

 

1.   NOTES

1. The next of kin will automatically assume the role of legal personal
2. Relationship means : Husband/Wife/Son/Daughter/Father/Mother t.c
3. Any change on the teacher’s records should be communicated immediately by the teacher to the Commission.

 

2. NAME  TSC No.                   ID/No.            .

(Full name in block letters)

 

3. Date of first appointment as (a) Untrained Teacher (UT) .

(b) Trained Teacher (P/P)                                        .

 

4. PERMANENT ADDRESS – P. O. Box ,Code                    , Town                                                               .

 

5. HOME DISTRICT , DIVISION                           ,LOCATION                                                 .

6.   DECLARATION:

I, Mr/Mrs/Miss/Dr/.                                                            ,ID/No.                                                                                         . hereby declare/ nominate the following as my next of kin and dependants:-

 

NEXT OF KIN

S/N	NAME(S)	AGE	RELATION	CONTACT ADDRESS/PHONE
1.
2.
3.
4.
5.

 

(Please turn to page 2)

 

 

DEPENDANTS

 

S/N	NAME(S)	AGE	RELATION	CONTACT ADDRESS/PHONE
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.

 

 

7. TEACHER’S SIGNATURE , DATE                                                                          .

 

 

8. NAME AND ADDRESS OF AREA CHIEF                                                       .

 

                                                         .

 

                                                         .

 

9. HEADTEACHER/DEPUTY HEADTEACHER/WITNESS

Name                                                  . Address                                                                                       . Sign.                                            , Date                                                                                            .

 

 

 

Official Stamp:                                     .