CITIZEN REGISTRATION FORM
Surname *
Other Names *
Kenyan Passport No. / ID No. *
Issued On
MM
/
DD
/
YYYY
Expiry Date
MM
/
DD
/
YYYY
Marital Status
Profession *
Student
Clear selection
If Yes, please provide name of institution
Residential Address
Email Address *
Telephone/Mobile No. *
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