Box Application

Box Application

Name as per ID *

Gender *

Identity type *

ID/Passport Number *

KRA Pin (Optional)

Email Address *

Mobile Number *

Alternative No

County of Residence *

Post Office *

Number of Months(Payment Period) *

Occupation/Field *

House/Office Number *

Street Name *

City *

Amount to Pay: Ksh(Amount includes Ksh. 560 for keys)

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