::Membership Enrollment Form

Kindly fill in the relevant details and submit the form.

We shall get back to you as soon as possible to formalise the membership.
Thank you.

Surname

TITLE

Other Names

SPOUSE (if applicable)

P O BOX

TOWN

Tel (LANDLINE)

CELL-PHONE

E-Mail

DATE JOINED

DATE PAID

PAYMENT

BALANCE

REASON FOR JOINING

NUMBER OF VEHICLES
Entry fee
KSHS 500
Annual Subscription
KSHS 3500
TOTAL
KSHS 4000

 

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