Registration Form
(Fill form and resend with scan/copy of deposit slip)
Full Name: _______________________________________________________________________________
Preferred name for badge____________________________________________________________________
Organization: _____________________________________________________________________________
Preferred Mailing address: ___________________________________________________________________
City: ________________________________ State/Province: _________________________________
Zip/Postal Code: ______________________
Country: _____________________________ Telephone: (______) ____________________________
Fax: (______) ________________________
Email: __________________________________________________________________
Payment Method:
⃣Cash deposit
⃣ Cheque Deposit
MPESA/⃣ Wire Transfer
Bank:______________________________________________________
Deposit Slip Number/MPESA/Transfer confirmation: _________________________________________
The fee is payable via bankers’ cheque or direct bank deposits to any of the following KCA University bank accounts:
1. Barclays Bank, Westlands Branch- Account Number 1352178, bank code: 073, Swift code: BARCKENX.
2. Barclays Bank,Moi Avenue Branch- Account Number 1766319, bank code: 075, Swift code: BARCKENX.
3. Standard Chartered Bank, Ruaraka Branch- Account Number 0102001171100, bank code: 002, Swift code: SCBLKENX.
4. Commercial Bank of Africa,Wabera Street Branch- Account Number 6432280015, bank code: 007, Swift code: CBAKENX.
5. MPESA PAYBILL