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
GIACHUNKU (BENSON KOOME, DANIEL MARETE, ERIC MUNENE, GEOFFREY MUNENE, NEWTON KINOTI, NEWTON KIRIMI, PETERSON MWANDIKI, RAMADHAN 2, Amani Dairy)
GIACHUNKU A (BENSON KOOME, DANIEL MARETE, ERIC MUNENE, GEOFFREY MUNENE, NEWTON KINOTI, NEWTON KIRIMI, PETERSON MWANDIKI, RAMADHAN 2, Amani Dairy)
KATHARE (BENSON KOOME, DANIEL MARETE, ERIC MUNENE, GEOFFREY MUNENE, NEWTON KINOTI, NEWTON KIRIMI, PETERSON MWANDIKI, RAMADHAN 2, Amani Dairy)
KIAMBUGI-MWIKI (BENSON KOOME, DANIEL MARETE, ERIC MUNENE, GEOFFREY MUNENE, NEWTON KINOTI, NEWTON KIRIMI, PETERSON MWANDIKI, RAMADHAN 2, Amani Dairy)
KIMORO (BENSON KOOME, DANIEL MARETE, ERIC MUNENE, GEOFFREY MUNENE, NEWTON KINOTI, NEWTON KIRIMI, PETERSON MWANDIKI, RAMADHAN 2, Amani Dairy)
KIMUCHIA-THIGAA (BENSON KOOME, DANIEL MARETE, ERIC MUNENE, GEOFFREY MUNENE, NEWTON KINOTI, NEWTON KIRIMI, PETERSON MWANDIKI, RAMADHAN 2, Amani Dairy)
LOWER MAKURI (BENSON KOOME, DANIEL MARETE, ERIC MUNENE, GEOFFREY MUNENE, NEWTON KINOTI, NEWTON KIRIMI, PETERSON MWANDIKI, RAMADHAN 2, Amani Dairy)
OFFICE (Amani Dairy)
UPPER MAKURI (BENSON KOOME, DANIEL MARETE, ERIC MUNENE, GEOFFREY MUNENE, NEWTON KINOTI, NEWTON KIRIMI, PETERSON MWANDIKI, RAMADHAN 2, Amani Dairy)
Preferred Bank
*
Select Bank
CAPITAL SACCO
CENTENARY SACCO
CO-OPERATIVE BANK
EQUITY BANK
KCB
M-PESA
NDOSHA
NO BANK
SOLUTION SACCO
SOUTHERN STAR SACCO
THAMANI SACCO
TRANSNATION SACCO
UNAITAS
YETU SACCO
Account Number
*
3. Next of Kin & Photo
Next of Kin Name
Next of Kin Phone
Relation
Passport Photo
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