Maisha Bora SACCO

Member Registration

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PERSONAL INFORMATION

Title

First Name *

Last Name *

Other Name

Date of Birth *

Gender *

Email Address *

KRA PIN Number

ID Type *

ID Number *

ID/ Passport Expiry Date Select the expiry month and year of your ID/Passport

Phone Number *

+254

Marital Status *

Country *

Nationality *

City/Town *

Postal/ZIP Code

County

Sub-County

Location/Ward

Current Physical address *

Occupation *

Postal Address *

EMPLOYMENT DETAILS

I am employed

Employer

Current Station/Location

Designation

Payroll Number

Nature of Business

Business Name

Business Location

MOBILE BANKING SERVICES

Would you like to be registered for Mobile Banking Services? *

Yes No

📱 Mobile banking allows you to check balances, apply for loans, and make transactions from your phone.

RECRUITER INFORMATION

Introduced by (Name) (Optional)

Introducer's Phone (Optional)

+254

Enter 9 digits starting with 7 or 1

Introducer's ID/Passport Number (Optional)

The ID or Passport number of the person who introduced you

NEXT OF KIN

ℹ️ Please provide details of your nominees who will benefit from your SACCO contributions in case of your demise.

1 Nominee 1 *

Full Name *

Relationship *

ID/Passport Number *

Phone Number *

+254

Date of Birth * If nominee is under 18, ID & Phone are optional; guardian details are required

Email Address

Allocation Percentage *

Total allocation must equal 100%

Residential Address *

👤 Guardian Details * (Required for nominees under 18 years)

Guardian Full Name *

Relationship to Nominee *

Guardian ID/Passport Number *

Guardian KRA PIN

Guardian Phone Number *

+254

Guardian Email Address

Guardian Residential Address *

📊 Total Allocation: 100% ⚠️ Must equal 100%

BENEVOLENT BENEFICIARY

Do you have dependants? *

Yes No

ℹ️ Please provide details of your dependants (people who rely on you financially).

1 Dependant 1 *

Full Name *

Relationship *

ID/Passport Number *

Phone Number *

+254

Email Address

Date of Birth * ID and Phone are optional for dependants under 18

Residential Address *

REQUIRED DOCUMENTS

📎 Required Documents to Accompany Membership Application Form:

One (1) recent coloured passport photograph
Copy of national ID card/passport
Copy of KRA PIN certificate
Evidence of bank account (cancelled cheque, bank statement, or debit card)

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Passport Photograph *

Upload one (1) recent coloured passport photograph

📄 Formats: JPG, PNG • 🗂️ Max size: 5MB

National ID/Passport Document *

Upload your National ID or Passport document

📄 Formats: JPG, PNG • 🗂️ Max size: 5MB

KRA PIN Certificate *

Upload copy of your KRA PIN certificate

📄 Formats: JPG, PNG • 🗂️ Max size: 5MB

Signature *

Upload a photo or scan of your signature

📄 Formats: JPG, PNG • 🗂️ Max size: 5MB

* I agree to the terms and conditions

Maisha Bora SACCO

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PERSONAL INFORMATION

👫 Spouse Information

EMPLOYMENT DETAILS

MOBILE BANKING SERVICES

RECRUITER INFORMATION

NEXT OF KIN

1 Nominee 1 *

👤 Guardian Details * (Required for nominees under 18 years)

BENEVOLENT BENEFICIARY

1 Dependant 1 *

REQUIRED DOCUMENTS

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Membership Terms and Conditions

A. MEMBERSHIP TERMS

B. MOBILE BANKING SERVICES TERMS

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