Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form. InstructionsBefore Filling this form, Kindly pay a registration and entrance fee of 2000/- through Mpesa . The Mpesa Receipt No will be required before submitting. Our Paybill Number is 979150. The Account number is your ID Number.1.APPLICATION FOR MEMBERSHIPThe Hon. Secretary P.O. Box 2973 – 00200, TEL.020-2246383/2250314 NAIROBI I hereby make an application for membership and agree to conform to the Societies By-Laws and any amendment thereof. Name *FirstLastMobile Number (SAFARICOM) *Date of BirthBank Name Official of Date Bank BranchBank Account NumberEmployment Status *EmployedSelf EmployedPayroll No. National ID Number *KRA Pin No. *Email *Official DesignationTerms of ServicePermanentContractEmployerEmployer AddressDepartmentStation2. NOMINATED NEXT OF KINI, the undersigned, in the event of my death whilst a member of the Society, hereby instruct the Society to pay all amounts due to me, less any debts to the Society, to the person named in this Section. The name of nominee can be given in a sealed letter. I understand that I may alter the name of the Nominated Next of Kin by filling in a subsequent Nominated Next of Kin Form.Nominated Next of Kin Full Names *Relationship to the ApplicantNational ID No. *Address of Next of KinMpesa Receipt Number( from SMS) *Phone NumberSubmit
