Self Registration Form
Payment Instructions
Amount:
Ksh 1,000
Paybill:
4156465
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
Mombasa
Nairobi
Lebanon
Qatar
USA
Turkana
Tana River
Dubai
Nyamira
Saudia
Nakuru
Gatundu
Narok
Mandera
No branch
Kajiado
Kericho
Kakamega
Marsabit
Turkey
Bugema
`
Israel
Email Address
ID Number
Referral ID (Optional)
Next of Kin
Next of Kin Phone
Passport Image
ID Image
Submit Application