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NATIONALITY Select Nationality Afghan Albanian Algerian American Andorran Angolan Antiguans Argentinean Armenian Australian Austrian Azerbaijani Bahamian Bahraini Bangladeshi Barbadian Barbudans Batswana Belarusian Belgian Belizean Beninese Bhutanese Bolivian Bosnian Brazilian British Bruneian Bulgarian Burkinabe Burmese Burundian Cambodian Cameroonian Canadian Cape Verdean Central African Chadian Chilean Chinese Colombian Comoran Congolese Costa Rican Croatian Cuban Cypriot Czech Danish Djibouti Dominican Dutch East Timorese Ecuadorean Egyptian Emirian Equatorial Guinean Eritrean Estonian Ethiopian Fijian Filipino Finnish French Gabonese Gambian Georgian German Ghanaian Greek Grenadian Guatemalan Guinea-Bissauan Guinean Guyanese Haitian Herzegovinian Honduran Hungarian Icelander Indian Indonesian Iranian Iraqi Irish Israeli Italian Ivorian Jamaican Japanese Jordanian Kazakhstani Kenyan Kittian and Nevisian Kuwaiti Kyrgyz Laotian Latvian Lebanese Liberian Libyan Liechtensteiner Lithuanian Luxembourger Macedonian Malagasy Malawian Malaysian Maldivan Malian Maltese Marshallese Mauritanian Mauritian Mexican Micronesian Moldovan Monacan Mongolian Moroccan Mosotho Motswana Mozambican Namibian Nauruan Nepalese New Zealander Ni-Vanuatu Nicaraguan Nigerien North Korean Northern Irish Norwegian Omani Pakistani Palauan Panamanian Papua New Guinean Paraguayan Peruvian Polish Portuguese Qatari Romanian Russian Rwandan Saint Lucian Salvadoran Samoan San Marinese Sao Tomean Saudi Scottish Senegalese Serbian Seychellois Sierra Leonean Singaporean Slovakian Slovenian Solomon Islander Somali South African South Korean Spanish Sri Lankan Sudanese Surinamer Swazi Swedish Swiss Syrian Taiwanese Tajik Tanzanian Thai Togolese Tongan Trinidadian or Tobagonian Tunisian Turkish Tuvaluan Ugandan Ukrainian Uruguayan Uzbekistani Venezuelan Vietnamese Welsh Yemenite Zambian Zimbabwean

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ADDRESS/RESIDENCE VILLAGE PARISH/SUBCOUNTY DISTRICT/STATE/PROVINCE Select District Abim Adjumani Alebtong Amolatar Amudat Amuria Amuru Apac Arua Budaka Bududa Bugiri Bugweri Buhweju Buikwe Bukedea Bukomansimbi Bukwo Bulambuli Buliisa Bundibugyo Bushenyi Busia Butaleja Butambala Buvuma Buyende Dokolo Gomba Gulu Hoima Ibanda Iganga Isingiro Jinja Kaabong Kabale Kabarole Kaberamaido Kalangala Kaliro Kalungu Kampala Kamuli Kamwenge Kanungu Kapchorwa Kasese Katakwi Kayunga Kibaale Kiboga Kibuku Kiruhuura Kiryandongo Kisoro Kitgum Koboko Kole Kotido Kumi Kween Kyankwanzi Kyegegwa Kyenjojo Lamwo Lira Luuka Luwero Lwengo Lyantonde Manafwa Masaka Masindi Mayuge Mbale Mbarara Mitoma Mityana Moroto Moyo Mpigi Mubende Mukono Nakapiripirit Nakaseke Nakasongola Namayingo Namutumba Napak Nebbi Ngora Ntoroko Ntungamo Nwoya Nyadri Otuke Oyam Pader Pallisa Rakai Rubirizi Rukungiri Sembabule Serere Sheema Sironko Soroti Tororo Wakiso Yumbe Zombo Other

PRIMARY LEAVING EXAMINATIONS Index Number School Name English Mathematics Social Studies Integrated Science Aggregates Result/Division

MALE PARENT/GUARDIAN DETAILS FIRST NAME LAST NAME

FEMALE PARENT/GUARDIAN DETAILS FIRST NAME LAST NAME