Organization Registration Form Organization Registration Form Part A: Particulars Name Physical Address P.O. Box Email Telephone Numbers Part B: Category Non-Governmental Organization (NGO) Faith-Based Organization (FBO) Institution Support Group Other (Specify): Registration Number Part C: Location of Activities Continents Countries Counties Towns Comments Part D: Representation How many PLWSD does the organization represent? How many PLWSCD have filled the registry Form A? Part E: Types of Activities Advocacy Capacity Building Support Clients Research Other (Specify): Comments Part F: Contact Person First Name Middle Name Last Name Designation Email Telephone Numbers Part G: Payment Details Pay Bill No.: 522522 Registration Fee (Ksh.): Account Number: Forward message to Mobile Number: Airtel: 0733 731 731 Safaricom: 0710 141 121 Form Signatures Form Filled By (Initials & Sign): Date: Computer Entry Done By: Date: Submit Please enable JavaScript for this form to work.
