Member Registration

SDA CHURCH KAHAWA SUKARI WELFARE GROUP

Member's Personal Information

First Name *

Last Name *

Other Names

Gender: *

Date of Birth

Telephone Number * Enter a 10-digit number (e.g., 0712345678)

Email Address *

ID Number *

National ID (Front Side) * Choose File Upload a clear image of the front side of your National ID.

National ID (Back Side) * Choose File Upload a clear image of the back side of your National ID.

Passport Photo * Choose File Upload a recent passport-sized photo.

Postal Address *

Current Residence *

Permanent Residence *

Occupation *

Marital Status: *

Residence Area *

Church Membership Type: *

Church Member Sabbath School

If Sabbath School Member, for how long?: *

Please Indicate Five church members who know you (one of whom MUST be an elder or church leader): *

Next of Kin Details

Next of Kin's Full Name *

Relationship to Member *

Next of Kin’s Telephone Contact * Enter a 10-digit number (e.g., 0712345678)

Next of Kin’s Email Address

Next of Kin’s Postal Address

Next of Kin’s ID Number

Next of Kin ID / Birth Certificate * Choose File Upload a clear image or PDF of Next of Kin's ID, or Birth Certificate if minor.

Member's Signature

Member's Signature (Upload Scan/Image) * Choose File Upload an image file (JPG, JPEG, PNG, GIF) of your signature. This is required for registration.

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