Full Membership

Title

Name (As you would like it to appear on the Certificate)

Gender

National ID Number

Phone Number

Do you have any form of disability? Yes No

Postal Address

Physical Address

County of Residence ( For Kenyans)

LinkedIn Profile

Highest Level of Education

Program of Study

Current Profession

Current Place of Work

Job Title

Date

Upload a Passport-Sized Photo for Your Membership Smart Card (Not a Selfie)

Images should be in format: jpeg, png, jpg

Any Comment (optional)

* I declare that the information given herein is correct to the best of my knowledge and belief, and, if approved, I agree to be bound by the Constitution of the Association as it now exists and as may hereafter be amended from time to time.

Please send registration fee of KE.1000 to M-Pesa Business No: 522533 Account No:7782321#mreg

Go to the Lipa na MPESA menu and select Paybill.

Business Number: 522533

Account Number: Enter 7782321#me

Enter the fare: KES 1000

Enter your PIN number.

Wait for the MPESA confirmation SMS.

Fill in this form and submit below.

Cell Phone Number (The Number used for M-Pesa Payment)

M-Pesa Transaction ID (e.g TE69MHLK8Q) *

Student Membership

Title

Name

Gender

National ID Number

Phone Number

Do you have any form of disability?
Yes No

Postal Address

Physical Address

County of Residence ( For Kenyans)

LinkedIn Profile

Name of School

Current Highest Level of Education

Current Year of Study

Current Semester of Study

Program of Study

Date of Membership

Upload a Passport-Sized Photo for Your Membership Smart Card (Not a Selfie)

Images should be in format: jpeg, png, jpg

Any Comment (optional)

Registration Fee

Pay with M-Pesa – STK Push

Pay with M-Pesa – Standard

Pay KES. 300 with MPESA - STK PUSH

Customer Care: 0715752644 / 0792523226

Enter your mobile phone number below and click Register and submit payment details button.
An STK Push prompt will appear on your phone automatically.
Enter your M-Pesa PIN on your phone.
Transaction completes instantly and you will receive Login Credentials and Membership card in your email you provided .

Enter Mobile Number for Payment

Pay Kes 300 with MPESA - Standard

Customer Care: 0715752644 / 0792523226

Instructions:

Go to the M-PESA menu on your phone.
Select Lipa na M-PESA.
Choose Paybill.
Enter the Business Number: 4182983.
Enter the Account Number: Your Name.
Enter the Amount: KES 300.
Enter your M-PESA PIN and confirm.
After payment, you’ll receive an SMS with a Transaction Code.
Enter the code below to verify your payment.

M-Pesa Transaction Code

Phone Number used

Associate Membership

Title

Name

Gender

National ID Number

Phone Number

Do you have any form of disability?
Yes No

Postal Address

Physical Address

County of Residence ( For Kenyans)

LinkedIn Profile

Current Highest Level of Education

Program of Study

Current Profession

Current Place of Work

Job Title

Date of Membership

Upload a Passport-Sized Photo for Your Membership Smart Card (Not a Selfie)

Images should be in format: jpeg, png, jpg

Any Comment (optional)

Registration Fee

Pay with M-Pesa – STK Push

Pay with M-Pesa – Standard

Pay KES. 500 with MPESA - STK PUSH

Customer Care: 0715752644 / 0792523226

Enter your mobile phone number below and click Register and submit payment details button.
An STK Push prompt will appear on your phone automatically.
Enter your M-Pesa PIN on your phone.
Transaction completes instantly and you will receive Login Credentials and Membership card in your email you provided .

Enter Mobile Number for Payment

Pay Kes 500 with MPESA - Standard

Customer Care: 0715752644 / 0792523226

Instructions:

Go to the M-PESA menu on your phone.
Select Lipa na M-PESA.
Choose Paybill.
Enter the Business Number: 4182983.
Enter the Account Number: Your Name.
Enter the Amount: KES 300.
Enter your M-PESA PIN and confirm.
After payment, you’ll receive an SMS with a Transaction Code.
Enter the code below to verify your payment.

M-Pesa Transaction Code

Phone Number used

Membership Registration

Organization Membership Form

Full Membership

Student Membership

Pay KES. 300 with MPESA - STK PUSH

Pay Kes 300 with MPESA - Standard

Instructions:

Associate Membership

Pay KES. 500 with MPESA - STK PUSH

Pay Kes 500 with MPESA - Standard

Instructions: