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