Online Application Portal – Registration
* Required Fields
| * ID/Passport Number: | |
| * Password: | |
| * Confirm Password | |
| Personal Details | |
| * Title: |
Select a title Mr Ms Mrs Miss |
| * Gender: | FemaleMale |
| * Surname: | |
| * First Name: | |
| Middle Name: | |
| * Phone Number: | |
| Alternate Phone Number: | |
| * Email: | |
| * Date of Birth: | |
| * Marital Status: |
Please select your Marital Status Married Single Divorced |
| * County: | Please select a county… Error |
| * Constituency: | |
| * Wards: | |
| * Physical Location: | |
| Current Postal Address: | |
| Current Postal Code: | |
| * Current City: | |
| Religion: | |
| Current Term of service: | |
| Current Position: | |
| Current Work Station: | |
| * Disabled ?: | YesNo |
| Disability Type: | |
Independent Electoral and Boundaries Commission
