Pamoja Kenya MN

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Pamoja Kenya MN

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Double Family Registration

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  2. Double Family Registration
  • Pamoja Kenya Double Family Registration Form

  • 1. NEW MEMBER INFORMATION

  • 2. SPOUSE

  • 3. NEXT OF KIN (Must be different name from the spouse)

  • 4. PARENTS

  • First NameMiddle InitialLast Name 
  • 5. CHILDREN

  • First NameMiddle InitialLast Name 
  • 6. SIBLINGS

  • First NameMiddle InitialLast Name 
  • 7. OTHER FAMILY REGISTRATION

  • First NameMiddle InitialLast Name 
  • First NameMiddle InitialLast Name 
  • 8. DECLARATION

  • by entering my name below and submitting my ID, I declare that the information provided on this form is accurate, true, and correct. I understand that any misrepresentation of material fact herein may render my membership null and void at the discretion of the Pamoja Kenya Board of Trustees. Upon registration, I agree to remain a Pamoja Kenya member for at least five (5) years after benefiting, failure to follow the signed agreement, Pamoja Kenya shall have a right to take a legal action against me to recover the total amount of any money given me.

  • Accepted file types: jpg.
  • 9. REFERRED BY:

  • First NameLast NameTelephone Number
  • 9. PAY YOUR REGISTRATION FEES AND FIRST SHARES

  • $0.00
  • American Express
    Discover
    MasterCard
    Visa
    Supported Credit Cards: American Express, Discover, MasterCard, Visa
     
  • WHAT NEXT?

    Click PayPal below to PAY and SUBMIT your form to Pamoja Kenya Officials

  • FOR OFFICE USE ONLY: Pamoja Kenya Reviewer

    Please note: Pamoja Kenya Official must complete this section upon review of this application.

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