Surname * First Name * Other Names * Mobile Number Home County BaringoBungomaBusiaElgeyo MarakwetMeruEmbuKisumuKisiiMombasa Type of Identity * Indentity CardBirth CertificatePassport--Select-- Date of Birth * Home County BaringoBungomaBusiaElgeyo Marakwet--select-- Email Address * Mobile Number 2 Town Number Your Gender --select--MaleFemale Parent/Guardian Details Parent/Guardian Name * Parent/Guardian Mobile Number * Parent/Guardian Email Parent/Guardian Alternative Mobile Number EDUCATION KCSE Index Number (Index/Year) * Secondary School Name * KCSE Mean Grade * AA-B+BB-C+CC-D+DD-E--select-- Register
