Form A

APPLICATION FOR FILING OF ADVANCED TRAINING AND UPGRADING CERTIFICATES.

Pursuant to the Medical Laboratory Technicians and Technologists Act CAP 253 A Laws of Kenya

DOCUMENT CONTROL

Serial: KMLTTB/UPGR/ADV/CPD /01

Version: 001

Date: 8TH APRIL, 2025

DATE

NAME

REGISTRATION NO.

FILE No (IDNO.)

CURRENT REGISTRATION LEVEL
Certificate Diploma Degree

APPLICATION TO UPGRADE FROM

INSTITUTION WHERE HIGHER TRAINING WAS OBTAINED

Training From

ADVANCED TRAINING DETAILS

Institution

Award/Qualification

From

Graduation Date

remove

Attachments

NB: ATTACH ALL THE APPLICABLE CERTIFICATES TOGETHER WITH THEIR ACADEMIC TRANSCRIPTS.