MEMBERSHIP REGISTRATIONFill in the form below to register as a member of ACMK Step 1 of 3 33% PART A : Membership ApplicationPlease input the following detailsPersonal InformationFill in the following detailsAttach Photo HereAccepted file types: jpg, gif, png, pdf.Kindly Upload your passport imageName* Mr.Mrs.MissMs.Dr.Prof.Rev. Prefix First Middle Last Phone*Input your current reachable phone contactDate of Birth* Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country Email* Enter Email Confirm Email Country of Residence if Not KenyanDate of Arrival In Kenya Educational BackgroundPlease fill in the following detailsSecondary/High School*UniversityUpload Certificates* Drop files here or Class of Membership Applied for:*CorporateGraduateDetails of Practical Professional Experience in Kenya*Work ExperiencePlease input the following detailsName of Employer First Last Phone contacts of EmployerYour designation at work(this section is does not apply if your application is for student membership) Declaration(With reference to the ACMK Constitution) I, agree that in the event of my confirmation to membership of any class in ACMK, I will be governed by the Constitution and By-Laws of the Association, as they are now or as they may hereafter be altered. Choice*I AgreeI do not AgreePayment DetailsMake registration fee payment (Kshs. 2,000 for Graduate Membership Application or Kshs. 5,000 for Corporate Membership Application) using the procedures below Go to M-Pesa Menu Proceed to “LIPA NA MPESA” Select “PAYBILL” Enter the following Business Number : 529901 In the account number enter : 3011 8175 83002 Enter amount : Enter your PIN: You will receive a MPesa message confirming you have transfered cash to JAMII BORA BANK account number 3011 8175 83002Payment ConfirmationPlease enter the Transaction Code below (MPesa or Bank Reference Code)Transaction/Reference Number :*CAPTCHA