MEMBERSHIP REGISTRATION FORM

This is a membership registration form for members of Old Town Residents Association.

Included are 4 sections:-

1. Standard details capture of members for creation of a database and also for OTRA's future reference.

2. Membership rates card particulars.

3. Payment details.

4. Hotline number.

This is a membership registration form for members of Old Town Residents Association.

Included are 4 sections:-

1. Standard details capture of members for creation of a database and also for OTRA's future reference.

2. Membership rates card particulars.

3. Payment details.

4. Hotline number.

1. STANDARD DETAILS

Upload you passport size photo

Drop your image here or click to select

Full names (i.e First name, Middle and Surname in accordance to ID or Passport) (Majina Kamili)

Age Bracket (Umri)

Email (Barua pepe)

Locality (Born and Raised)

Please Specify:

Country of Residence

Mobile Number including country code (Numbari ya simu)

Profession

Please Specify:

2. MEMBERSHIP RATE CARDS

Below are the different yearly rates, as per geographical location.

Please choose ONE type only per membership

2. MEMBERSHIP RATE CARDS

Below are the different yearly rates, as per geographical location.

Please choose ONE type only per membership

A. East African Community

Please Specify:

B. Outside Africa (UK/ USA/ Canada/ EU /GCC)

Please +kshs 112 (mpesa charges from send wave to paybill)

If received less amount you will be required to remit the difference, however if you subscribed more the difference goes to donation box

Payment frequency:

All the above rates are yearly. The frequency options are as per below:

3. PAYMENT DETAILS

Account No - Name as per Identification Card (ID)

Attach copy of the bank telegraphic transfer (TT)

Drop your image here or click to select

Confirmation No

4. HOTLINE NUMBER

Any concerns, queries or confirmations can be communicated using this number:

+254 7575 55403

Disclaimer: The information in the form gathered above is for the sole purposes of data collection and membership recruitment purposes for OTRA ONLY. It is of strict confidentiality. It may not be reproduced or circulated. Any intended further use of the information by OTRA will be communicated to the recipients first.

OTRA AIM-MISSION-VISION

4. HOTLINE NUMBER

Any concerns, queries or confirmations can be communicated using this number:

+254 7575 55403

OTRA AIM-MISSION-VISION

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