Member Bio-Data Form

*Please, Fill All Fields*

Personal Info:

Chuna Member Number

National ID/Passport No

Payroll No

First Name

Middle Name

Last Name

Email

Phone Number

Phone Number 2

KRA PIN

Postal Address

Postal/ ZIP Code

City

County / Province

House Number

Employer Name

Department

Employment Term

Public Institution Near You

Next Of Kin:

Surname

First Name

Last Name

National ID/Passport No

Relationship

Mobile No

Email Address

Dependants:

First Name

Last Name

Date of Birth

Relationship

Beneficiary:

First Name

Last Name

Date of Birth

Relationship

Allocation(%)

email

File Uploads

National ID Copy

KRA PIN Copy

Payslip

Passport Size Photo

Appointment Letter