Dependants Form
Principal Member Details
Surname
Other Names
Personal No.
Designation
Identity No.
Date of Birth
Gender
Select Gender
Male
Female
Mobile No.
Job Group
Terms of Service
Select Terms
Permanent
Contract
Department
Select Department
Executive
Finance & Economic Planning
Agriculture, Livestock & Fisheries
Water & Environment
Education & ICT
Health, Medical & Public Health
Physical Planning, Lands & Housing
Public Works
Trade & Co-operatives
Board
Gender, Home Affairs, Culture & Youth Affairs
DPSM
Kilifi Municipality
Malindi Municipality
Duty Station
Marital Status
Select Marital Status
Single
Married
Divorced
Spouse Details
Spouse Name
Spouse DOB
Spouse ID Number
Spouse Mobile No.
Spouse Gender
Select Gender
Male
Female
Children Details (Max 4)
(if any, otherwise leave blank)
Child 1 Name
Child 1 DOB
Child 1 Gender
Select Gender
Male
Female
+ Add Child
Attachments
(If applicable)
Marriage Certificate or Affidavit (PDF/Image)
Birth Certificates (ZIP/PDF/Image)
Admissions Letter (PDF)
Submit