Provider registration

Provider Registration

Step 1 of 4: Account Type & Basic Identity

Account Type *

Individual Provider

Company Provider

Full Name *

Email Address *

Phone Number *

Kenya: Exactly 9 digits, no leading zero. No spaces allowed.

Date of Birth *

Password *

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Password must be at least 8 characters long

Confirm Password *

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Identification Document *

Home Address *

Initializing map...

House/Apartment Number

Street/Road

Area/Location

Landmark

Latitude

Longitude