Signup – Kenya Society for Immunology

Section 1: Personal Information

Prefix

First Name *

Middle Name

Last Name *

Gender *MaleFemale

Email Address *

Street Address

Apartment, suite, etc

City

State/Province

ZIP / Postal Code

Country

Mobile Phone *

Work Phone

Occupation *

Qualifications

Affiliations

Work Address

City

ZIP / Postal Code

Country

Areas of your Academic/Professional Interests

Nationality

Country of Residence

Membership Type *Full Ordinary Membership - Kes 2000Full Time Students - Kes 500

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If you are a student, please provide evidence of university registration

Payment Method *Postal or Money OrderChequeM-Pesa

Please Note

Please send the confirmation of payment to the secretary (secretary@ksi.or.ke) to complete registration.
$3 is your contribution towards IUIS membership
KSI, Standard Chartered Bank, Karen Branch, Account Number: 0100335277100
or Stan chart paybill: 329329 - Acc: 0100335277100

The information provided above will also be used to keep you informed about KSI events in future.