Affiliate Societies Registration

A. Society Details

Proposed Name 1 *

Proposed Name 2

Proposed Name 3

Nature / Type *

Will the society form branches? *

Objective 1 *

Objective 2 *

Objective 3 *

Objective 4

Objective 5

B. Registered Office

County *

Subcounty *

Street / Road *

Plot / House No. *

Postal Address *

Postal Code *

Land/Premises Ref (if owned)

C. Office Bearers

Chairperson

ID Type *

ID Number *

Citizenship *

First Name *

Middle Name

Surname *

KRA PIN

Gender *

Date of Birth *

Phone *

Email *

Postal Address

Postal Code

Passport Photo (JPG/PNG) *

Signature (image) *

Secretary

ID Type *

ID Number *

Citizenship *

First Name *

Middle Name

Surname *

KRA PIN

Gender *

Date of Birth *

Phone *

Email *

Postal Address

Postal Code

Passport Photo (JPG/PNG) *

Signature (image) *

Treasurer

ID Type *

ID Number *

Citizenship *

First Name *

Middle Name

Surname *

KRA PIN

Gender *

Date of Birth *

Phone *

Email *

Postal Address

Postal Code

Passport Photo (JPG/PNG) *

Signature (image) *

Other Office Bearers (optional)

D. Membership

Present Number of Members *

Entrance Fee (KES)

Monthly Subscription per member (KES)

Class 1 – Eligible Persons *

Class 2 – Eligible Persons

E. Sources of Funds

Source of funds 1 *

Source of funds 2

Source of funds 3

F. Required Uploads

Constitution (PDF, ≤ 5 MB) *

List of Members (PDF/XLS, ≤ 5 MB) *

Letters of No Objection (if applicable) – multiple

Additional Documents (optional) – PDF/PNG/JPG

G. Declaration

I confirm that the details provided are true, and that the society is non-political and non-profit-making. *

Declarant Full Name *

Position *

Become a legally registered YIMBIK affiliate

Affiliate Societies Registration (Kenya-compliant)

Chairperson

Secretary

Treasurer