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User Registration - For Industrial Attachment
First Name:
Middle Name:
Surname:
Phone Number:
E-Mail:
Gender:
--select gender--
Female
Male
Date of Birth:
ID Number :
Residence
County:
--select county--
SELECT * FROM county WHERE country_id = 110 ORDER BY title
Baringo
Bomet
Bungoma
Busia
Elgeyo Marakwet
Embu
Garissa
Homa Bay
Isiolo
Kajiado
Kakamega
Kericho
Kiambu
Kilifi
Kirinyaga
Kisii
Kisumu
Kitui
Kwale
Laikipia
Lamu
Machakos
Makueni
Mandera
Marsabit
Meru
Migori
Mombasa
Murang'a
Nairobi
Nakuru
Nandi
Narok
Nyamira
Nyandarua
Nyeri
Samburu
Siaya
Taita Taveta
Tana River
Tharaka-Nithi
Trans-Nzoia
Turkana
Uasin Gishu
Vihiga
Wajir
West Pokot
Ethnicity:
--select ethnicity--
Bajuni
Basuba
Borana
Burji
Dasenach
Dorobo
El Molo
Embu
Gabbra
Galjeel
Galla
Gosha
Kalenjin
Kamba
Kenyan Americans
Kenyan Arabs
Kenyan Asians
Kenyan Europeans
Kenyan Somali
Kikuyu
Kisii
Konso
Kuria
Leysan
Luhya
Luo
Maasai
Mbeere
Meru
Mijikenda
Njeps
Nubi
Orma
Pokomo
Rendille
Sakuye
Samburu
Swahili-Shirazi
Taita
Taveta
Teso
Tharaka
Turkana
Walwana
Not Applicable
Education / Attachment Details
Name of Institution:
Field of Study:
--select field of study--
Arts
Business and Finance
Engineering
Geology
Geomatics
Human Resources
Information and Communications Technology
Science
Year of Study:
--select year of study--
1
2
3
4
5
Start Date
(Attachment period is 3 months)
:
Upload Attachment Letter from your institution (.pdf):
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