NIDA Number / Kitambulisho cha Mkazi au Mkimbizi

Passport Number / Namba ya Pasipoti

TIN Number / Namba ya TIN

Citizenship / Uraia Burundi Democratic Republic of the Congo Kenya Rwanda South Sudan Uganda Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antigua & Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bonaire Bosnia & Herzegovina Botswana Brazil British Indian Ocean Ter Brunei Bulgaria Burkina Faso Cambodia Cameroon Canada Canary Islands Cape Verde Cayman Islands Central African Republic Chad Channel Islands Chile China Christmas Island Cocos Island Colombia Comoros Congo Cook Islands Costa Rica Cote DIvoire Croatia Cuba Curacao Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Ter Gabon Gambia Georgia Germany Ghana Gibraltar Great Britain Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guyana Haiti Hawaii Honduras Hong Kong Hungary Iceland Indonesia India Iran Iraq Ireland Isle of Man Israel Italy Jamaica Japan Jordan Kazakhstan Kiribati Korea North Korea South Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malaysia Malawi Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Midway Islands Moldova Monaco Mongolia Montserrat Morocco Mozambique Myanmar Nambia Nauru Nepal Netherland Antilles Netherlands (Holland, Europe) Nevis New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Norway Oman Pakistan Palau Island Palestine Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Island Poland Portugal Puerto Rico Qatar Republic of Montenegro Republic of Serbia Reunion Romania Russia St Barthelemy St Eustatius St Helena St Kitts-Nevis St Lucia St Maarten St Pierre & Miquelon St Vincent & Grenadines Saipan Samoa Samoa American San Marino Sao Tome & Principe Saudi Arabia Senegal Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa Spain Sri Lanka Suriname Swaziland Sweden Switzerland Syria Tahiti Taiwan Tajikistan Thailand Togo Tokelau Tonga Trinidad & Tobago Tunisia Turkey Turkmenistan Turks & Caicos Is Tuvalu United Kingdom Ukraine United Arab Emirates United States of America Uruguay Uzbekistan Vanuatu Vatican City State Venezuela Vietnam Virgin Islands (Brit) Virgin Islands (USA) Wake Island Wallis & Futana Is Yemen Zaire Zambia Zimbabwe

First Name / Jina la Kwanza

Middle Name / Jina la Kati

Last Name / Jina la Mwisho (la Ukoo)

Date of Birth / Tarehe ya Kuzaliwa

Gender / Jinsia
Male / Mwanaume Female / Mwanamke

Martial Status / Hali ya Ndoa
Single / Sina Ndoa Married / Nina Ndoa Divorce / Nina Talaka Widowed / Mgane au Mjane

Mobile Number / Namba ya simu ya mkononi

Email Address / Barua Pepe

Password / Neno Siri

Confirm Password / Thibitisha Neno Siri

Security Question / Swali la Usalama

Security Answer / jibu la Ulinzi

I have read and accept the Terms and Conditions.

I have read and understand the Privacy Policy Statement.