Application Form For Agripreneurs

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MAKUENI COUNTY GOVERNMENT

P.O BOX 78 – 90300


MAKUENI.

APPLICATION FORM FOR AGRIPRENEURS FOR PROFILING


AGRICULTURE VALUE CHAINACTORS IN MAKUENI COUNTY

1. Eligibility Criteria:

a) Must be between 20 – 45 years of Age with a national ID


b) Must be an active resident of the ward in which the profiling exercise is being
undertaken
c) Minimum academic qualification of a post-secondary qualifications from a recognized
institution, preferably in Agricultural Sciences, Agribusiness, Statistics, Social
Sciences, Community Development & related disciplines
d) Demonstrate some experience in agriculture or agribusiness & interactions with
farmers.
e) Must own a smart phone & be computer literate.
f) Must be able to communicate in Kiswahili, English & the local dialect in their locality.
g) Ability & willingness to remain personally involved & committed on full time basis.
h) Strong past experience in community mobilization & training farmers on
agriculturalvalue chains

2. Personal Details

Full name of
Applicant________________________________________________________

Gender ___________ Tel No. ________________ ID


No.__________________

County ______________________ Sub-county


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_________________________

Ward _______________________ Village


____________________________

Highest level of education (if any) __________________ Grade acquired:


________________

Agriculture value chain in which applicant is


involved_________________________________

Role in the Specific Agriculture Value Chain


_______________________________________

3. Personal details:
Name of next of Kin ID/No Ward Village Tel contact

4. Declaration

I confirm that the information shared in this form is accurate and that I shall cooperate in
collection of accurate data as required by the program if and when selected.

Name :………………………………….Signature:…………………….. Date:…………….

NB: Copies of the following MUST be attached;


1. National ID
2. KCSE Certificate
3. Post-secondary certificates

NB: Both ID and KCPE certificate must be attached

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