Zoghori Sacco Membership Registration

Please complete this form noting that all fields marked with an Asterisk (*) are MANDATORY.

Please note that the following will be required for successful registration:

Passport Photo & Signature (Mandatory)
National ID (Mandatory)
KRA Pin (Mandatory)
Passport Document (Diaspora members)
Payment of 1,515/= via Paybill 4077167, Account No: your ID No with #CA suffix (e.g., 1234567#CA)

I hereby apply for membership and agree to conform to the Society's, having read and understood the By-Laws herein attached and amendments thereof.

Personal Details

Please upload your photo.

Salutation *

Please select a salutation.

First Name *

Please enter your first name.

Middle Name

Last Name *

Please enter your last name.

Date Of Birth *

Please enter your date of birth.

Identity Document No. *

Please enter your ID number.

Upload your Identity Document *

Please upload your ID document.

Email Address *

Please enter a valid email address.

M-Pesa Phone Number [+254 Format] *

Please enter a valid phone number (e.g., +254712345678).

Other Phone No. [+254 Format]

Gender *

Please select your gender.

Marital Status *

Please select your marital status.

Place of Residence

Proposed Monthly Contribution (Figures) *

Please enter your proposed contribution.

Proposed Monthly Contribution (Words)

Preferred Mode of Remittance *

Check-off

Standing Order

M-Pesa/Direct Debit

Other:

Please select at least one remittance option.

Employment Details

Type of Employment *

Please select your employment type.

Next Of Kin Details

I, the undersigned, in the event of my death whilst a member of ZOGHORI SACCO, hereby instruct the society to pay all amounts due to me, less my debts to the society, to the person(s) named in this section. I understand that I may alter the name(s) of the Nominated Next of Kin(s) by filling a fresh nomination form.

Full Name *

ID No *

Date of Birth *

Relationship *

Phone Number *

Email Address

Percentage