TEACHER PROFESSIONAL DEVELOPMENT (TPD) PROGRAM  OFFICIAL DATA CAPTURE FORM (COHORT 4)
THANK YOU FOR REGISTERING WITH KEMI FOR THE TPD INTRODUCTROY MODULE. KINDLY FILL THE FORM BELOW TO ENABLE US CAPTURE YOUR PERSONAL DETAILS REQUIRED TO COMPLETE YOUR ENROLMENT. USE CAPITAL LETTERS AND ENSURE ACCURACY OF THE INFORMATION PROVIDED.

Email *
1. SURNAME *
2. MIDDLE NAME
3. FIRST NAME *
4. CELLPHONE NO. (Both Mpesa and WhatsApp Number where Applicable) *
5. TSC NO. *
6. GENDER *
7. NAME OF YOUR SCHOOL / INSTITUTION *
8. (a) CATEGORY OF YOUR SCHOOL / INSTITUTION *
8. (b)  If you Answered "Other" Please Specify
9. LEVEL OF YOUR SCHOOL / INSTITUTION *
10. YOUR DESIGNATION *
11. COUNTY (where your School / Institution is located) *
12. SUB-COUNTY      (where your school / institution is located) *
13. (a) Do you have a Special Education Needs? *
I13. (b) If yes to Q13 (a). above, please indicate the category of special education needs
14. (a)  Please pay Kshs 1050 registration fee to complete your application.  


Paybill No: 222222
Account number: KEMIAP
(b). Enter your MPESA transaction code
 *
A copy of your responses will be emailed to the address you provided.
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