Names:

Membership:

Passport Photo: Attach Passport.

Contact Phone Number:

Alternative Phone Number:

ID Number:

Location:

Employer:

ID Image: Attach ID image.

Email Address:

Next Of Kin Name:

Next of Kin Number:

Referral: Select Referral (leave blank if self) BENARD BARONGO MOSOMI - MWA-1 Ronald Mosomi - MWA-455 Mathew Nyachieo - MWA-455 Mathew Onyinkwa - MWA-455

Branch Select Branch Utawala Syokimau

Ensure the file has these headings (name, phone_number, ID, officer) on the first row

Choose a .csv or .xlsx file containing your clients: