Self Registration Form
Payment Instructions
Amount:
Ksh 1,000
Paybill:
4166319
Account:
REGISTRATION
Use:
Your Mpesa confirmation code to verify and continue registration.
Full Name
Phone Number
Mpesa Confirmation Code
Send OTP
Enter OTP
Select Branch
-- Choose Branch --
Kisii
Email Address
ID Number
Referral ID (Optional)
Next of Kin
Next of Kin Phone
Passport Image
ID Image
Submit Application