2nd Year Online Application

Basic Information
Name*
Surname First Name Middle Name
Contacts: (The most preferable means of communication is via email)
P.O. Box / Street Address
City / Town
Postal Code
Country
Email
Mobile Phone
Gender*
- Male
- Female
Date of Birth*
MM slash DD slash YYYY
Nationality*
- Kenyan
Nearest Relative (Not Spouse) to be notified in case of emergency. Must have a phone.
Name*
Surname First Name Middle Name
Relationship*
Residential Address*
Mobile Phone*

Statement of Truth
I hereby state that all the information submitted in this application is correct and true. If Rhema Kenya is notified that any of the information contained herein is false, it will be justified grounds for my dismissal.
Privacy Policy*
- I have read and agree to the Privacy Policy
Consent*
- I consent to receive communications from Rhema Kenya and their staff
Signature*
Date*
MM slash DD slash YYYY
Passport Photo Upload (in jpg, png, pdf, or gif formats)
Accepted file types: jpg, png, gif, pdf, Max. file size: 300 MB.
Email
This field is for validation purposes and should be left unchanged.

Basic Information