MaziwaPro360
Smart Dairy Management System - Membership Portal
Member Application Form
Please provide accurate details for verification
1. Personal Information
First Name
*
Last Name
*
Phone (Format: 254...)
*
Email Address
ID / Passport Number
Gender
*
Choose...
Male
Female
2. Route & Banking Information
Milk Collection Route
*
Select Route
GIAMPAMPO (ERICK KIRIMI)
GICUCHA (JULIUS MWENDA)
KAANWA (LOYD MAWIRA)
KAMBUNGU (PETER MWENDA)
KANGUTU (PATRICK KIRIMI)
KIANGONDU (JACKIN MIRITI)
KIERENI (DENIS KIRIMI)
KIGWAMBURA (BENSON KIMANTHI)
KIINI (NICHOLAS MWENDA, MORRIS MUTUGI)
MAGUNDU (ANDERSON GITONGA)
MUBUKURO (MORRIS MURIMI)
MUNGONI (FRIDAH MAKENA, MICHAEL MWENDA)
MUTHENGE (DANIEL MWANDIKI)
MUTUNGURUNI (JULIUS MWENDA)
NDAGANI (JOY KANGAI, MORRIS MURIMI, BRIAN MAWIRA)
NTUNTUNI (HUMPREY NTWIGA)
RUKINDU (HUMPREY NTWIGA)
Preferred Bank
*
Select Bank
CENTENARY SACCO
CO-OPERATIVE BANK
COUNTY SACCO
DOSHA SACCO
EQUITY BANK
FAMILY BANK
KCB
M-PESA
NO BANK
SIDIAN BANK
SOLUTION SACCO
SOUTHERN STAR SACCO
THAMANI SACCO
TRANSNATION SACCO
YETU SACCO
Account Number
*
3. Next of Kin & Photo
Next of Kin Name
Next of Kin Phone
Relation
Passport Photo
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