KASSAA | Kanyamfwa Secondary School Alumni Association

Note: To be completed by every member wishing to join the Alumni Association.

Membership Number (to be issued by office)

Home Constituency *

1. PERSONAL INFORMATION

a). Full Name *

b). ID. Card/Passport number *

Upload Passport photo

c). Current Postal Address *

d). Permanent Physical Address *

e). Current Physical Address *

f). Telephone Number (Mobile) *

g). Email Address*

h). Year in Kanyamfwa, From....to.... *

i). Payment/(Mpesa Transaction Code/Membership No.) reference number

2. NEXT OF KIN

a). Full Name of Next of Kin *

b). Relationship *

c). ID/Passport No *

d). P.O. Box *

e). Current Residence *

f). Signature (Use ID/passport No as signature) *

g). Date *

h). Next of Kin Telephone *

3. DECLARATION

i). I am aware that it is an offence to provide any information knowingly or recklessly, which is false or misleading in connection with my application for membership of the association within the provisions of the association by laws and other regulations in Kenya. I am also aware that omitting material information intentionally or un-intentionally shall be construed to be an offence and may lead to disqualification or other appropriate action as per the bylaws if discovered.

ii). I certify that the information given above is complete and accurate to the best of my knowledge, and that there are no other facts relevant to this application of which the association and other Regulatory Authorities should be aware.

iii). I undertake to inform the association of any changes, which may arise in future.

iv). I further confirm that I have agreed to abide by the provisions of the By-Laws of the association and other regulations or as may be revised from time to time.

Applicant Signature (Use ID/passport No as signature) *

Date *

Mandatory Documentation to Support an Application for registration (Checklist)

The office undertakes to treat all information and documents provided with utmost privacy taking into account individual rights on data protection as provisioned by Kenyan law. Such information and documents shall only be used strictly to serve the interest of this Alumni. Please check the box below to confirm submission of all the necessary details

Duly filled form, Registration & monthly fee paid

4. FOR OFFICIAL USE ONLY

Database updated by: *

Updated by signature (Use ID/passport No as signature) *

Date *

If rejected Comment *

Kindly note - Any missing information without explanation shall be treated as deliberate and may lead to disqualification.

ANNEX 1-BANK ACCOUNT DETAILS

BANK: KENYA COMMERCIAL BANK

ACCOUNT NAME: KANYAMFWA SEC. SCHOOL ALUMNI

ACCOUNT NUMBER: 1333850409

BRANCH: XXXXXXXXXXXXXXXXXXXX

BANK CODE: XXXXXXXXXXXXXXX

BRANCH CODE: XXXXXXXXXXXXX

SWIFT CODE: XXXXXXXXXXXXXX

MPESA PAY BILL NUMBER: 522533 ACCOUNT: 7919102

Kanyamfwa Secondary School Alumni Association

Opening Hour

Call Us

Email Us

Membership Registration

Note: To be completed by every member wishing to join the Alumni Association.

1. PERSONAL INFORMATION

2. NEXT OF KIN

3. DECLARATION

Mandatory Documentation to Support an Application for registration (Checklist)

4. FOR OFFICIAL USE ONLY

ANNEX 1-BANK ACCOUNT DETAILS

Office Contact

Services Areas

Useful Pages

Kanyamfwa Secondary School Alumni Association

Opening Hour

Call Us

Email Us

Membership Registration

Note: To be completed by every member wishing to join the Alumni Association.

1. PERSONAL INFORMATION

2. NEXT OF KIN

3. DECLARATION

Mandatory Documentation to Support an Application for registration (Checklist)

4. FOR OFFICIAL USE ONLY

ANNEX 1-BANK ACCOUNT DETAILS

Office Contact

Services Areas

Useful Pages

Newsletter