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
CHERA-KIBINGO (MARTIN MUTWIRI, ISAAC MURANGIRI)
KIERENI-IRUKU (FREDRICK MUGAMBI)
KIUNGUNI-KIRIGUNI (ONESMUS WACHIRA)
MUIRU (JULIETA MUTHONI)
NKUMBO-MUCWA (ONESMUS WACHIRA)
NTHIMA-RWANJUKI (MORRIS MWENDA, ONESMUS WACHIRA)
WERU-KAMBUNGU (MARTIN MUTWIRI)
WERU-KIERENI (LOYD MUTWIRI, ONESMUS WACHIRA)
Preferred Bank
*
Select Bank
CAPITAL SACCO
CENTENARY SACCO
CO-OPERATIVE BANK
COUNTY 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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